(PS10-15) A Cross-cultural Examination of Associations Between Psychological (In)flexibility, Psychological Distress, and Somatic Symptoms

Empirical evidence supported psychological flexibility (PF) to be a protective factor against psychological distress and psychological inflexibility (PI) to be a risk factor of mental health symptoms. However, most studies examining these two transdiagnostic constructs were conducted in Western countries. It is unclear whether the effects of PF and PI on mental health symptoms will hold up in Eastern countries, especially when past research has reported east-west cultural differences in symptom expression. Specifically, individuals in eastern cultures endorsing heightened psychological distress also tended to report more somatic symptoms compared to those in western cultures. To investigate the role of PF and PI on psychological distress and somatic symptoms across both cultures, 252 participants in Thailand and 194 participants in the US completed the Multidimensional Psychological Flexibility Inventory (MPFI), the Kessler Psychological Distress Scale-10 (KPD-10), and the Patient Health Questionnaire-15 (PHQ-15). Multi-group structural equation modeling was used to test a model illustrating the effects of PF, PI on psychological distress (KPD-10) and somatic symptoms (PHQ-15) among participants from Thailand and the US. Shared variance was assumed for psychological distress and somatic symptoms and age was entered as a covariate. The model demonstrated good fit (X² (62)= 92.39, CFI=.97, TLI=.96, RMSEA = .05, SRMR=.07). The PI= >somatic symptoms path was significant (β = .62, p < .01) only among the Thai sample, whereas PF= >somatic symptoms was positively significant (β = .34, p=.03) among the US sample. Path PI= >psychological distress (β = .61-67, p < .01) was significant in both models. Constraining all paths revealed significant differences between both models (X² (4)= 26.31, p < .01). The results suggested potential cultural differences in the effects of PF, PI and symptom expression.