Validation of the Hungarian Version of the Cognitive Fusion Questionnaire (CFQ-7)

J Rat-Emo Cognitive-Behav Ther (2025) 43:23 https://doi.org/10.1007/s10942-025-00583-4 Abstract The aim of the study is the adaptation of the 7-item version of the Cognitive Fusion Questionnaire (CFQ-7) for the Hungarian sample. The factor structure of CFQ-7, the invariance of the structure in different groups, and its relationship with depression, anxiety and stress were previously confirmed by several different studies. This study discusses these analyses within one framework, and the invariance between the different subgroups in a broader context. The sample consisted of 1231 participants (average age 29.35, SD = 11.10). Mainly women took part in the study (n = 805, 75.56%). Most participants were single (n = 494, 41.1%) and had a secondary school degree (714, 58.0%). The participants completed the Cognitive Fusion Questionnaire (CFQ-7), Acceptance and Action Questionnaire-II (AAQ-II), Depression Anxiety Stress Scale (DASS-21), Satisfaction With Life Survey (SWLS) and White Bear Suppression Inventory (WBSI). The results confirm the one-factor structure of the CFQ-7 (χ2 = 69.24, df = 12, p <.001, χ2/df = 5.37, CFI = 0.985, TLI = 0.974, RMSEA = 0.062 [90% CI 0.048, 0.077], SRMR = 0.020.) with adequate internal consistency (Cronbach’s alpha = 0.918) and test-retest reliability (r =.665). The measurement tool shows configural, metric, and scalar invariance in groups separated by age, gender, education and psychological treatment history. Its strong correlation with psychological inflexibility (AAQ-II) and general tendency to suppress thoughts (WBSI) (r =.79 and r =.62); moderate correlation with general psychological distress (DASS-21; r =.59), depression (r =.57), anxiety (r =.59) and stress (r =.61); finally life satisfaction (SWLS; r = −.38) proves external validity of the CFQ-7. The one-factor structure of the questionnaire was confirmed, and its items can be well adapted to Acceptance Commitment Therapy, and also to Cognitive Therapy interventions. Its factorial invariance can be confirmed in different groups. However due to the characteristics of the sample - mainly women, young adults and those without a psychiatric history participated in the study -, further examination of the CFQ-7 in a clinical sample with current psychiatric conditions would be useful. Accepted: 4 February 2025 © The Author(s) 2025 Validation of the Hungarian Version of the Cognitive Fusion Questionnaire (CFQ-7) AnettSzabó-Bartha1· NikolettEisenbeck2· SándorRózsa1,3 · MátéSzondy4,5 · VeronikaMészáros1 Extended author information available on the last page of the article 1 3 A. Szabó-Bartha et al. Keywords Cognitive fusion questionnaire (CFQ-7) · Factor analysis · Validity · Reliability Introduction The third wave of behavioral psychotherapy represents an important area of modern psychotherapy. ‘Third wave psychotherapies’ comprise a heterogeneous group of treatments, including Acceptance and Commitment Therapy (ACT; Hayes et al., 1999), Dialectical Behavior Therapy (DBT; Linehan, 1993), Integrative Behavioral Couples Therapy (IBCT; Christensen & Doss, 2017), Mindfulness-Based Cognitive Therapy (MBCT; Segal et al., 2018) and several others. The factors that unite these new methods are acceptance, mindfulness, cognitive defusion, dialectics and values. These methods open up treatment possibilities for various conditions, including personality disorders, chronic depression, anxiety disorders, eating disorders, and many others (Kahl et al., 2012). Acceptance and Commitment Therapy (ACT) is a transdiagnostic treatment approach (framed in the cognitive behavioral tradition), where the central source of psychopathology is the construct of psychological inflexibility (Gloster et al., 2020). Psychological inflexibility is defined as “the rigid dominance of psychological reactions over chosen values and contingencies in guiding action” (p. 678, Bond et al., 2011), which often occurs when individuals attempt to avoid experiencing unwanted internal events. Therefore, the general goal of ACT is to increase psychological flexibility, that is diminishing the role of literal thought (“cognitive defusion”) and to encourage the person to contact psychological experience - directly, fully, and without needless defense (“psychological acceptance”) - while at the same time behaving consistently with one’s chosen values (Hayes et al., 2004). Cognitive Fusion, Defusion and their Correlates Cognitive fusion is a key aspect of psychological inflexibility in the framework of ACT. It can be described as the process by which thoughts about an event merge with the actual event (Assaz et al., 2023; Hayes et al., 1999). Cognitive fusion implies that people react to thoughts as if they were literal reality and thus may act in a way that is inconsistent with their actual environment and available choices (Gillanders et al., 2014a, b). In this sense, cognitive fusion represents the phenomenon by which individuals believe the literal meaning of their thoughts instead of viewing them as transient internal states (e.g., the thought “I am a loser”, is equivalent to the psychological experience of failure) (Greco et al., 2008, p. 20). When fused with their thoughts, individuals tend to respond to them as if they were absolute facts (“I am a loser’’), triggering experiential avoidance strategies (attempts to avoid, escape, modify or control the experience) (e.g.: not apply for a job) and turning these internal experiences more painful (Hayes et al., 2006). Various studies have shown that higher levels of cognitive fusion are associated with higher levels of depression, anxiety, burnout, lower levels of quality of life and life satisfaction, and maladaptive coping strategies (e.g., experiential avoidance, fre1 3 23 Page 2 of 18 Validation of the Hungarian Version of the Cognitive Fusion… quency of automatic thoughts) (Fergus et al., 2012; Gillanders et al., 2014a, b; Shi et al., 2024; Zucchelli et al., 2020). Coyne and Wilson (2004) described how parents’ fusion with their negative thoughts (e.g. “I am a bad parent.”, “I cannot tolerate my child’s behavior.”) may lead to dysfunctional parenting behaviors such as anger outbursts, withdrawal, or overcontrol to avoid sadness and despair. Gillanders and his colleagues (2015) conducted a quantitative cross-sectional study among adults with various cancer diagnoses which proved that cognitive fusion was the strongest predictor of anxiety symptoms, while cancerrelated cognitions and avoidant coping were the strongest predictors of depressive symptoms and quality of life. Measurement of Cognitive Fusion Several scales and questionnaires have been developed to measure cognitive fusion and defusion. Most of them were designed to measure fusion in specific populations: the Believability of Anxious Feelings and Thoughts Questionnaire (BAFT; Herzberg et al., 2012) was developed for non-clinical undergraduates and anxious community samples; the Automatic Thoughts Questionnaire (ATQ; Hollon & Kendall, 1980) measures depressogenic thought frequency and is widely used in depression studies to assess the impact of cognitive therapy; ATQ was subsequently altered to assess the believability of depressogenic thoughts (ATQ-B; Zettle & Hayes, 1986); the Cognitive Fusion Questionnaire - Body Image (CFQ-BI; Lucena-Santos et al., 2017) assesses body image-related cognitive fusion; the Cognitive Fusion Questionnaire– Food Craving (CFQ-FC; Duarte et al., 2016) was designed to assess cognitive fusion with undesirable thoughts regarding food craving and urges to eat; the Stigmatizing Attitudes Believability Scale (Hayes et al., 2004) measures substance abuse therapists´ stigmatizing thoughts about their clients; the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; Greco et al., 2008) was developed for children and adolescents; the AFQ-Y was recently adapted for nonclinical adults (Schmalz & Murrell, 2010) and for adults with anxiety disorders; Drexel Defusion Scale (DDS; Forman et al., 2012) measures ability to achieve psychological distance from 10 unpleasant internal experiences. There is a special available instrument includes cognitive fusion items as part of measurement of the psychological inflexibility construct, in which other ACT processes are also present: the Psychological Inflexibility in Pain Scale —Cognitive Fusion subscale (PIPS; Wicksell et al., 2008) measures psychological flexibility, including cognitive fusion, specifically related to pain. Cognitive Fusion Questionnaire (CFQ; Gillanders et al., 2014a, b) was designed to assess fusion with cognition in general, rather than with particular forms of cognition (e.g., anxious thoughts), and was tested in a series of studies designed to generate evidence of validity and reliability for the measure involving over 1,800 people across diverse samples (e.g., community-dwelling healthy adults, people with multiple sclerosis, sample of different mental health difficulties, people with major depressive disorder, and caregivers of people with dementia). The CFQ started from a pool of 42 items and was progressively improved by reducing it to a 7-items final version (Gillanders et al., 2014a, b). The original studies provide good evidence of the CFQ’s unifactorial structure, reliability, temporal stability, validity, discriminant validity, and sensitivity to treatment effects. The seven-item scale (CFQ-7) has become the 1 3 Page 3 of 18 23 A. Szabó-Bartha et al. most widely used self-report instrument for assessing cognitive fusion in both clinical and research settings (Bolderston et al., 2019). Psychometric Properties of the Seven-Item Cognitive Fusion Questionnaire The CFQ-7 has been translated and validated in numerous languages, including Brazilian Portuguese (Lucena-Santos et al., 2017), Catalan (Solé et al., 2016), Chinese (Zhang et al., 2014), French (Dionne et al., 2016), German (China et al., 2018), Greek (Zacharia et al., 2021), Italian (Donati et al., 2021; Policardo et al., 2023), Japanese (Shima et al., 2016), Korean (Kim & Cho, 2015), Persian (Soltani et al., 2022), Spanish (Romero-Moreno et al., 2014; Ruiz et al., 2017) and Turkish (Kervancioğlu et al., 2023). Studies usually support the one-factor structure, but some studies achieve an adequate-fit of the one-factor structure with correlations between the items’ error terms (Kim & Cho, 2015; Lucena-Santos et al., 2017). Lucena-Santos and colleagues (2017) allow for correlations between items 1 and 2, and also items 2 and 3; while Kim and Cho (2015) place a correlation between items 6 and 7. The internal consistency and test-retest stability of a single-dimensional structure are usually adequate. Configural, scalar and metric invariance can also be confirmed on different samples (Gillanders et al., 2014a, b). In Latin-speaking countries Ruiz and colleagues (2017) confirmed gender invariance. In addition to gender invariance, Ruiz and colleagues (2017) found a lower cognitive fusion mean score in men sample of undergraduates, and participants without a psychiatric history also had lower scores. In RomeroMoreno and colleagues’ (2014) and Losada and colleagues’ (2006) suggested that clinical depressive symptoms are positively associated with scores on cognitive fusion, but only in the case of female dementia caregivers. Similar differences were found in a previous study in which female caregivers with scores close to clinical depressive symptoms presented higher frequencies of dysfunctional thoughts. According to Nolen-Hoeksema and Jackson (2001), rumination as a coping strategy is used more frequently by women than men. It can contribute to their greater tendency toward cognitive fusion. Ruiz and colleagues (2017) also supported the invariance of the measuring instrument in certain clinical conditions, but there is no information on whether the invariance of CFQ-7 can be established regardless of age and education levels. Thus, in the present study, we examined the invariance of the Cognitive Fusion Questionnaire-7 by gender, clinical condition, age and education. Additionally, some studies have examined the external validity of the CFQ-7 in terms of psychological flexibility, mindfulness, quality of life, life satisfaction, anxiety, and depression (e.g. Dionne et al., 2016; Donati et al., 2021; Gillanders et al., 2014a, b; Kim & Cho, 2015). The phenomenon of cognitive fusion occurs more prevalent in states of anxiety and depression. However, it can also be observed in life situations characterized by low well-being or stress. Cognitive fusion appears during certain psychological challenges or in connection with certain clinical conditions (e.g. China et al., 2018; Donati et al., 2021; Kim & Cho, 2015). The second aim of this paper is to examine the external validity of the CFQ-7. The present study focuses on validating the Hungarian version of the Cognitive Fusion Questionnaire in a community sample. The study examined (a) the factor structure of the Hungarian version of the CFQ-7, (b) respectively the measurement 1 3 23 Page 4 of 18 Validation of the Hungarian Version of the Cognitive Fusion… invariance across age, gender, education, and psychological treatment history of the participants (c) evaluate its psychometric properties (external validity) in relation to other constructs, such as psychological inflexibility, general tendency to suppress thoughts, satisfaction with life and distress. Method Participants The sample consisted of Hungarian-speaking participants recruited from community samples via email and social media. The present study was part of a larger online investigation about psychological flexibility and its elements, such as mindfulness, experiential avoidance and value-driven life (The ethics license was approved by the Károli Gáspár University of Reformed Church, ethical permission number: 369/2016/2/P and BTK-PI/8323-1/2024). After explaining the purpose of the study (i.e. to better understand their personal experiences), the participants provided informed consent, understanding that participation was voluntary and anonymous. A total of 1231 participants completed the questionnaires with a men age of 29.35 years old (SD = 11.10 years, minimum 18, maximum 60 years). The majority of respondents were women (n = 805, 75.56%), high school graduates (n = 714, 58.0%). The respondents were mainly single (n = 494, 41.1%) or in a relationship (n = 324, 26,3%). Most of the participants did not have children (n = 892, 72.5%). 77.7 (n = 956) percent of the respondents had no previous psychological treatment history, and 22.3 (n = 275) percent of the respondents had. We examined the temporal stability of the CFQ-7 over a 1-month interval with part of the sample. This subsample consisted mainly of women (n = 152, 91.6%), married people (n = 59, 35.5%), and people with secondary school degrees (n = 103, 62.0%), and people who had no children (n = 97, 58.4%). The average age was 30.57 years (SD = 9.93 years), and a significant percentage of this subsample had previous psychological treatment history (n = 54, 32.5%) (see detailed information - Table 1). Measures Seven-Item Cognitive Fusion Questionnaire (CFQ-7) The Cognitive Fusion Questionnaire is a 7-item measure that is designed to assess the single construct of cognitive fusion. Respondents rate each item which reflects an aspect of cognitive fusion on a 1 to 7 Likert scale, with 1 (never true) and 7 (always true). Higher scores indicate higher levels of cognitive fusion; the possible score ranges from 7 to 49. In our translation process, we followed the guidelines provided by the International Test Commission (ITC Guidelines for Translating and Adapting Tests (2nd ed.), 2017). The translation process began with two independent questionnaire translations performed by separate translators. We employed translators who were native Hungarian speakers and resided in Hungary to provide essential knowledge and expertise in the target culture. In addition to knowing the target language 1 3 Page 5 of 18 23 A. Szabó-Bartha et al. and cultural contexts, they possessed knowledge of the content of the test and general testing principles. Following this, a review team (consisting of both translators and an additional reviewer) compared and discussed the different translated versions. This collaborative effort aimed to reconcile discrepancies and produced a unified final version of the questionnaire. After the translation, the questionnaire was retranslated into English, and a comparison between the original and retranslated versions was conducted to identify and address any inconsistencies, ensuring conceptual equivalence and linguistic accuracy. Concerning the cultural adaptation we emphasize that the „target culture”—Hungary—shares many characteristics of what Henrich et al. (2010) describe as WEIRD (Western, Educated, Industrialized, and Democratic). While Hungary might differ somewhat in terms of economic indicators, these differences are not as pronounced in the domains of cultural values, cognitive styles relevant to the constructs measured by the questionnaire. In the initial validation of the original measurement tool, the CFQ-7 demonstrated excellent internal consistency and good test-retest reliability. Moreover, the CFQ has a coherent, simple, and theoretically consistent factor structure that appears to be stable across diverse samples (Gillanders et al., 2014a, b). The differential item functioning analysis showed that CFQ-7 is invariant across different types of populations; thus, it can be used in both clinical and non-clinical contexts (Donati et al., 2021). There was a strong correlation between CFQ-7 and psychological inflexibility (AAQ-II; r =.75; p <.001), and ruminative response style (RSQ; r =.84; p <.001) (Gillanders et al., 2014a, b). Table 1 Demographic parameters of the sample Total sample Sample of temporal stability Frequency % Frequency % Gender Men 274 22.3 14 8.4 Women 957 77.7 152 91.6 Age (years) 18–25 689 56.0 72 43.4 26–40 292 23.7 60 36.1 41–60 250 20.3 34 20.5 Highest level of education Secondary school degree 714 58.0 103 62.0 University degree 517 42.0 63 38.0 Marrital status Single 494 40.1 50 30.1 In relationship 324 26.3 39 23.5 Cohabitation 131 10.6 18 10.8 Married 282 22.9 59 35.5 Number of children 0 892 72.5 97 58.4 1116 9.4 25 15.1 2 139 11.3 26 15.7 3 63 5.1 17 10.2 4 17 1.4 0 0 5 2 0.2 1 0.6 6 2 0.2 0 0 Psychological treatment No 956 77.7 112 67.5 Yes 275 22.3 54 32.5 1 3 23 Page 6 of 18 Validation of the Hungarian Version of the Cognitive Fusion… Acceptance and Action Questionnaire-II (AAQ-II) The AAQ-II (Bond et al., 2011) contains 7 items to measure psychological inflexibility. Participants rate how true each statement is true for them by using a 7-point Likert scale ranging from 1 (never true) to 7 (always true). The total scores range from 7 to 49, with higher scores indicating greater psychological inflexibility. The scale was translated into Hungarian and then translated back into English by researchers fluent in both languages. The internal consistency of the questionnaire for the sample used in the study is 0.89. Depression, Anxiety and Stress Scale (DASS-21) The Depression, Anxiety and Stress Scale (DASS-21; Lovibond & Lovibond, 1995) was implemented in this study to measure general psychological distress. Each item on this questionnaire describes a negative emotional state experienced in the last week, rated on a 4-point Likert scale ranging from 0 (did not apply to me at all) to 3 (applied to me very much, or most of the time). The measure consists of 21 items that are organized into three subscales assessing depression, anxiety, and stress, with each subscale containing seven items. The questionnaire has a hierarchical structure. The subscales can also be added. In this case, the instrument measures general psychological distress. The maximum scores are 42 for each subscale and 126 for general psychological distress. Higher scores indicate more frequent symptoms. As with the original version (Lovibond & Lovibond, 1995), the Hungarian DASS-21 has shown good internal reliability in the overall sample, with alphas for depression, anxiety, stress and general psychological distress of 0.88, 0.83, 0.84 and 0.93, respectively. Satisfaction with Life Survey (SWLS) The SWLS (Diener et al., 1985) measures self-perceived subjective well-being using five items such as “In most ways, my life is close to ideal”. The items were scored on a 7-point Likert-type scale (1 = strongly disagree; 7 = strongly agree). The maximum score is 35; higher scores indicate higher life satisfaction. The SWLS has good psychometric properties, with a Cronbach’s alpha of 0.84 (Martos et al., 2014). In the present study, internal validity for the total sample was 0.86. White Bear Suppression Inventory (WBSI) The White Bear Suppression Inventory (WBSI; Wegner & Zanakos, 1994) consists of 15 items with five response alternatives, ranging from 1 (totally disagree) to 5 (completely agree), which measure people’s general tendency to suppress thoughts. Responses were summed to yield a score ranging from 15 to 75 (Muris et al., 1996). The internal consistency of the WBSI was good (Cronbach’s alpha = 0.89), and testretest correlation was satisfactory (r =.80; (Muris et al., 1996). The sample of our study had an internal consistency (Cronbach’s alpha) of 0.91. 1 3 Page 7 of 18 23 A. Szabó-Bartha et al. Data Analysis First, we tested the factor structure of the CFQ-7 using confirmatory factor analysis with the robust maximum likelihood (MLR) estimator because violations of univariate and multivariate normality were observed. Considering the excellent sample size of over 1000 people, we used the following fit indices during confirmatory factor analysis (Kyriazos, 2018). The χ2-test compares the covariance matrix of the factor model and the covariance matrix of the observed model. In case of a large sample, the probability of Type II error increases at this index, so it is difficult to find a properly fitting model. Thus, several authors recommend its distribution with degrees of freedom (χ2/df), the value of which is accepted below 5. In case of larger samples, the use of the Comparative Fit and Tucker-Lewis indices is also an excellent choice, the values of which are considered acceptable above 0.900 and excellent above 0.950. Comparative Fit Index (CFI) evaluates the fit of the observed model on a continuum between the worst-fitting null model and the perfectly fitting saturated model. The Tucker-Lewis Index (TLI) is also a comparative goodness-of-fit index that shows how well the covariance matrix of the observed variables fits the hypothetical factor model. Among the error indicators, we considered SRMR and RMSEA, which calculate the difference between the observed correlations and the correlations assumed by the factor model. The smaller their value, the better the model fits the assumed model, so in the case of SRMR and RMSEA, a value below 0.080 is acceptable, and in the case of RMSEA, a value below 0.050 is excellent (Browne & Cudeck, 1992; Hu & Bentler, 1998; Schreiber et al., 2006). Since our sample consisted mainly of women (n = 805, 75,56%) and younger people (mean age of 29.35, SD = 11.10 years), we felt it was important to test the configural, metric, and scalar invariance of the factor structure, which enables a more detailed analysis of the structure of the questionnaire in different sub-samples. To check for factorial invariance, multigroup confirmatory factor analysis (MCFA) was conducted across age groups, sex (male/female), education (secondary school/ university degree), and psychological treatment history (yes/no) in the entire sample. Multigroup factor analysis is suitable for analyzing whether the structural characteristics of the measuring instrument are the same in the compared groups and whether it is not distorted by group-specific characteristics (Gregorich, 2006). Three nested models were adopted: (1) a configural model in which all factor parameters were freely estimated; (2) a weak factorial invariance model (metric), in which item loadings were constrained to be equal across groups; and (3) a scalar invariance model, in which the equality of thresholds or intercepts of the items were constrained to be equal across groups. We took into account Kline ‘s(2016) recommendation that at least 100 people per group be compared during multigroup confirmatory factor analysis. Successively restrictive models were compared with the Satorra-Bentler scaled χ2 difference tests using scaling correction factors and with CFI, RMSEA, and SRMR difference scores, the latter serving as indices for final decisions. As the sample size was large, changes of ≤ −.010 for CFI, ≤.015 for RMSEA and ≤.030 / ≤.010 for SRMR (depending on the level of testing) showed invariance (Chen, 2007). Finally, the external validity and test-retest reliability were tested with a Kendall-tau correlation. Taking into account Cicchetti’s (1994) criteria, the test-retest reliability 1 3 23 Page 8 of 18 Validation of the Hungarian Version of the Cognitive Fusion… between 0.4 and 0.59 is fair, between 0.60 and 0.74 is good, and above 0.75 is excellent. For the procedures used, the significance level was set at ≤.005. Analyses were performed using SPSS 29.0 and Mplus (Muthén & Muthén, 2017). Results Confirmatory Factor Analysis of the CFQ-7 The unidimensional structure of the CFQ-7 was tested using CFA and showed an inadequate fit of RMSEA (χ2 = 240.85, df = 14, p <.001, χ2/df = 17.20, CFI = 0.941, TLI = 0.911, RMSEA = 0.115 [90% CI 0.102, 0.128], SRMR = 0.036). Modification indices were checked for suggestions to improve the model: error covariance was added for items 1 (“My thoughts cause me distress or emotional pain.”) and 2 (“I get so caught up in my thoughts that I am unable to do the things that I most want to do.”) (with MI = 98.45), and for items 4 (“I struggle with my thoughts”) and 5 (“I get upset with myself for having certain thoughts”) (with MI = 85.85). Each item focuses on negative events that can be linked to thoughts (struggle, sadness, helplessness). After implementing these modifications, an adequate fit was found (χ2 = 64.24, df = 12, p <.001, χ2/df = 5.35, CFI = 0.985, TLI = 0.974, RMSEA = 0.062 [90% CI 0.048, 0.077], SRMR = 0.020.) (see Table 2). In addition, no standardized factor loading was below 0.695, indicating a proper fit of individual items. The internal consistency (Cronbach’s alpha) was 0.918. We also examined the temporal stability of the instrument over a month interval. The test-retest reliability of the CFQ-7 was r =.665. Table 2 The one-factor model of CFQ in the entire sample (N = 1231) - standardized factor loadings (with STD YX standardization) and error covariance estimates are displayed Item Standard factor loading Error term CFQ1 My thoughts cause me distress or emotional pain. [A gondolataim szorongást vagy szenvedést okoznak érzelmileg.] .780 0.014 CFQ2 I get so caught up in my thoughts that I am unable to do the things that I most want to do. [A gondolataim annyira a hatalmukba kerítenek, hogy képtelen vagyok azokat a dolgokat csinálni, amiket a leginkább szeretnék.] .737 0.017 CFQ3 I over-analyse situations to the point where it’s unhelpful to me. [Túlságosan sokat elemzek helyzeteket, addig a pontig, hogy az már nem hasznos számomra.] .805 0.014 CFQ4 I struggle with my thoughts. [Küzdök a gondolataim ellen.] .759 0.016 CFQ5 get upset with myself for having certain thoughts. [Megharagszom magamra, amiért bizonyos gondolataim vannak.] .695 0.018 CFQ6 I tend to get very entangled in my thoughts. [Hajlamos vagyok nagyon belegabalyodni a gondolataimba. ] .797 0.014 CFQ7 It’s such a struggle to let go of upsetting thoughts even when I know that letting go would be helpful. [Rendkívül nehéz számomra elengedni a zavaró gondolatokat, még akkor is, ha tudom, hogy hasznos lenne elengedni őket.] .854 0.011 Notes: r (between CFQ1 and CFQ2) = 0.363; r (between CFQ4 and CFQ5) = 0.333 1 3 Page 9 of 18 23 A. Szabó-Bartha et al. Fergus, T. A., Valentiner, D. P., Gillen, M. J., Hiraoka, R., Twohig, M. P., Abramowitz, J. S., & McGrath, P. B. (2012). Assessing psychological inflexibility: The psychometric properties of the avoidance and fusion questionnaire for youth in two adult samples. Psychological Assessment, 24(2), 402–408. https://doi.org/10.1037/a0025776 Forman, E. M., Herbert, J. D., Juarascio, A. S., Yeomans, P. D., Zebell, J. A., Goetter, E. M., & Moitra, E. 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Authors and Affiliations AnettSzabó-Bartha1· NikolettEisenbeck2· SándorRózsa1,3 · MátéSzondy4,5 · VeronikaMészáros1 Anett Szabó-Bartha [email protected] Máté Szondy szondy[email protected] 1 Karoli Gaspar University of the Reformed Church in Hungary, Institute of Psychology, Budapest, Hungary 2 Universidad de Sevilla, Faculty of Psychology, Sevilla, Spain 3 Washington University in St. Louis, Department of Psychiatry, St. Louis, US 4 Pazmany Peter Catholic University, Institute of Psychology, Budapest, Hungary 5 Jewish Charity Hospital, Budapest, Hungary 1 3 23 Page 18 of 18