(PS3-1) A Preliminary Examination of Psychological Flexibility as a Mediator in the Relationship Between Youth Health-related Anxiety and Family Accommodation

Abstract Text: The role of family accommodation in the development and maintenance of youth anxiety is well-documented, but the mechanisms underlying this relationship remain unclear. One promising avenue for improving familial accommodation and anxiety symptoms may be via enhancing psychological flexibility (PF) through acceptance and commitment therapy (ACT). There is growing research on the promise of PF as an important treatment target for both youth and adults, particularly for anxiety and related problems. The purpose of this study was to test whether PF mediated the relationship between youth health-related anxiety and family accommodation. Data were drawn from a sample of 30 adolescents (ages 12-17) with clinically elevated health-related anxiety, plus one caretaker each (N = 60), who participated in a randomized, waitlist-controlled trial of telehealth ACT for health-related anxiety. A series of mediation analyses were conducted to assess whether PF (rated by caregivers and adolescents) mediated the relationship between adolescent health-related anxiety and caregiver-reported family accommodation. Results indicated a significant relationship between adolescent health-related anxiety and familial accommodation (ps < .05). However, neither caregiver nor adolescent PF acted as a mediator for this relationship. These findings suggest the need for further research into therapeutic mechanisms for targeting familial accommodation for adolescents with anxiety disorders, particularly within ACT. This study has several limitations, including the use of a small sample and cross-sectional data. Future research should rely on larger, more diverse samples to better understand the relationships between child illness anxiety, family accommodation, and PF.