ACTsocially: The (Dis)Similarities of ACT for Changing Internalizing and Externalizing Symptomatology in Adolescence

Change in Core Social Fears

The CSFS-A is a self-report questionnaire designed to assess adolescents' experiences of anxiety and behavioral avoidance across a range of commonly encountered social situations. Originally comprising 34 items answered twice - once for anxiety intensity and once for avoidance frequency - items are rated on a five-point Likert scale (1 = none / never, 5 = very much / almost always) for each dimension. In the refined measurement model, this scale is conceptualized in terms of three core social fear dimensions (i.e. Interaction, Performance, and Observation) and a general avoidance factor. Each of the resulting subscales (Observation, Performance, Interaction) and the General Avoidance factor yields a composite score reflecting the intensity of social fears or the degree of avoidance behavior. Internal consistency values for these scales were demonstrated to be acceptable to good across community and clinical adolescent samples.

Change in Disruptive Behavior

The DBDRS is a 45-item hetero-report scale for the assessment of DSM-V symptoms of attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD). Items (e.g., "Argues with adults") are rated using a four-point Likert-type scale (0 = "not at all" to 3 = "very much"). The DBDRS is organized into four subscales - inattention, hyperactivity/impulsivity, oppositional defiant disorder, and conduct disorder. For the current work, only the ODD scale will be used in the intervention group of Study I, both in its original version for caregivers' (i.e., parents/teachers) report and in a version designed within this work for adolescents' self-report. The original version achieved an excellent level of internal consistency (α = 0.93 for the ODD scale). Invariance testing also suggested that the scale's internal structure is similar across key demographics such as age and sex.

Change in Aggressive Behaviors

The RPEQ is a 14-item self-report scale that assesses aggression, victimization and prosocial behavior. Each item is presented in two versions, one for practicing a given behavior and another for receiving that behavior. For the current work only the practice of aggression measures will be used within the intervention group of Study I. Items are rated on 5-point Likert scale (ranging from 1 = "never" to 5 = "a few times a week") and are organized into overt aggression, relational aggression, and reputational aggression. Factors achieved at least acceptable internal consistency values with Cronbach's alpha values of .88 for overt aggression, .75 for relational aggression, and .91 for reputational aggression. Evidence was also found in favor of the construct validity of these measures.

Change in Psychological Flexibility

The MPFI-24A is a 24-item self-report scale for the assessment of psychological flexibility (PF) and inflexibility (PI) that will be used to assess all groups considered in this research. The scale comprises 12 subscales, representing the six PF processes and the six PI processes. Items (e.g., "I opened myself to all of my feelings, the good and the bad") are answered on a 6-point Likert scale (ranging from 1 = 'never true' to 6 = 'always true') regarding how true the item was for the respondent in the previous 2 weeks. In the adolescent version, the composite indices (PF and PI) showed excellent internal consistency (α = .90 and α = .85, respectively) and the 12 factors revealed acceptable reliability with values that varied between .61 and .83.

Change in Mental Health

The MHC-SF is a 14-item self-report scale for the assessment of adolescents' mental health estimated from the perceived degree of emotional, social and psychological well-being; it will be used to assess all groups considered in this research. Items are answered on a 5-point Likert scale (ranging from 0 = "never" to 5 = "every day") regarding the number of times during the previous month the respondent felt a certain way. The used Portuguese version achieved at least good levels of internal consistency (α = 0.90 on the global scale and between 0.80 and 0.85 on the subscales.