Identifying and describing feelings and psychological flexibility predict mental health in men with HIV

Background Difficulty identifying and describing feelings ( DIDF ) and psychological flexibility ( PF ) predict poor emotional adjustment. Objective To examine the relationship between DIDF and PF and whether DIDF and low PF would put men undergoing cancer screening at risk for poor adjustment. Design Longitudinal self‐report survey. Methods Two hundred and one HIV ‐infected men who have sex with men participated in anal cancer screening at two time points over 14 weeks. Psychological flexibility was assessed by the A cceptance and A ction Q uestionnaire II and DIDF by the T oronto A lexithymia S cale‐20. We also measured depression, anxiety, stress ( DASS ) and health‐related quality of life ( QOL ; SF ‐12). Results Both DIDF and PF were reliable predictors of mental health. When levels of baseline mental health were controlled, greater DIDF predicted increases in T ime 2 depression, anxiety and stress and decreases in mental and physical QOL . The link between PF and mental health was entirely mediated by DIDF . Conclusions Being chronically low in PF could lead to greater DIDF and thereby worse mental health. Having more PF promotes the ability to identify and differentiate the nuances of pleasant and unpleasant emotions, which enhances an individual's mental health. Intentionally enhancing men's ability to identify and describe feelings or PF may assist them to better manage a range of difficult life experiences such as health screenings and other potentially threatening information. Statement of contribution What is already known on this subject? Difficulties identifying and describing feelings (DIDF); components of alexithymia and psychological flexibility (PF) both predict emotional adjustment. A cross‐sectional study has identified that alexithymia and PF are related concepts. Cancer screening programmes can have difficult psychological impacts. What does this study add? The longitudinal design supported cross‐sectional findings that DIDF and PF are related concepts. The link between PF and mental health was mediated by DIDF. Enhancing DIDF or PF may assist psychological responses to health screening.