Experiential avoidance in the context of obsessions: Development and validation of the Acceptance and Action Questionnaire for Obsessions and Compulsions

The unwillingness to remain in contact with obsessions and anxiety (i.e., experiential avoidance, EA) may explain how normally occurring unwanted intrusive thoughts develop into clinical obsessions as seen in obsessive-compulsive disorder (OCD). Studies examining the relationship between EA and OC symptoms are mixed, potentially because the existing self-report measure of EA (i.e., the Acceptance and Action Questionnaire, AAQ-II) is a general measure that does not adequately capture EA specific to obsessions and compulsions. Thus, we aimed to develop and evaluate an OC-specific version of the AAQ-II. First, we used exploratory factor analysis to empirically reduce an initial pool of 49 items (adapted from original AAQ-II items to reference “intrusive thoughts”) to 13 items. A two-factor solution (Valued Action and Willingness) provided the best fit to the data, accounting for 60.57% of the variance. Second, the reduced AAQ-OC was administered, along with other self-report measures, to an independent sample of adults. The AAQ-OC subscales evidenced good internal consistency as well as convergent, discriminant, and incremental validity. Future work examining the psychometric properties of the AAQ-OC in a clinical sample, as well as the measure's treatment sensitivity are needed.