Although cyber victimization has been suggested as a significant risk factor for the development of adolescents’ depression, the underlying psychopathological process that mediates this relationship needs further exploration. Based on the psychological inflexibility model, this study aimed to examine cognitive fusion and experiential avoidance as serial mediators in the relation between cyber victimization and depression. A total of 556 Chinese adolescents completed a set of online self-report questionnaires measuring cyber victimization, cognitive fusion, experiential avoidance, and depression. A bias-corrected bootstrap approach was used to test the serial mediation model. The results showed that cyber victimization predicted adolescents’ depression not only directly but also indirectly through three paths: the mediating role of (1) cognitive fusion and (2) experiential avoidance, and (3) the serial mediating role of cognitive fusion and experiential avoidance. These findings provide insight into the interventions for depression in adolescent cyber victims.
AssazD. A.TyndallI.OshiroC. K. B.RocheB. (2022). A process-based analysis of cognitive defusion in Acceptance and Commitment Therapy. Behavior Therapy. https://doi.org/10.1016/j.beth.2022.06.003
2.
BaldwinJ. R.ArseneaultL.CaspiA.MoffittT. E.FisherH. L.OdgersC. L.AmblerA.HoutsR. M.MatthewsT.OugrinD.Richmond-RakerdL. S.TakizawaR.DaneseA. (2019). Adolescent victimization and self-injurious thoughts and behaviors: A genetically sensitive cohort study. Journal of the American Academy of Child and Adolescent Psychiatry, 58(5), 506–513. https://doi.org/10.1016/j.jaac.2018.07.903
3.
BardeenJ. R. (2015). Short-term pain for long-term gain: The role of experiential avoidance in the relation between anxiety sensitivity and emotional distress. Journal of Anxiety Disorders, 30, 113–119. https://doi.org/10.1016/j.janxdis.2014.12.013
4.
BardeenJ. R.FergusT. A. (2016). The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumatic stress symptoms. Journal of Contextual Behavioral Science, 5(1), 1–6. https://doi.org/10.1016/j.jcbs.2016.02.002
5.
BeckA. T.SteerR. A.BrownG. K. (1996). Manual for the Beck depression inventory-II. Psychological Corporation.
6.
BolderstonH.GillandersD. T.TurnerG.TaylorH. C.MhaoileoinD. N.ColemanA. (2019). The initial validation of a state version of the Cognitive Fusion Questionnaire. Journal of Contextual Behavioral Science, 12, 207–215. https://doi.org/10.1016/j.jcbs.2018.04.002
7.
BrochadoS.SoaresS.FragaS. (2017). A scoping review on studies of cyberbullying prevalence among adolescents. Trauma Violence & Abuse, 18(5), 523–531. https://doi.org/10.1177/1524838016641668
8.
CalveteE.OrueI.EstevezA.VillardonL.PadillaP. (2010). Cyberbullying in adolescents: Modalities and aggressors’ profile. Computers in Human Behavior, 26(5), 1128–1135. https://doi.org/10.1016/j.chb.2010.03.017
9.
CaoJ.JiY.ZhuZ. (2013). Reliability and validity of the Chinese version of the acceptance and action questionnaire-second edition (AAQ-II) in college students. Chinese Mental Health Journal, 27(11), 873–877. https://doi.org/10.3969/j.issn.1000-6729.2013.11.014
10.
CarvalhoS. A.Pinto-GouveiaJ.GillandersD.CastilhoP. (2019). Pain and depressive symptoms: Exploring cognitive fusion and self-compassion in a moderated mediation model. The Journal of Psychology, 153(2), 173–186. https://doi.org/10.1080/00223980.2018.1507990
11.
CassidyW.FaucherC.JacksonM. (2013). Cyberbullying among youth: A comprehensive review of current international research and its implications and application to policy and practice. School Psychology International, 34(6), 575–612. https://doi.org/10.1177/0143034313479697
12.
ChenQ.LoC. K.ZhuY.CheungA.ChanK. L.IpP. (2018). Family poly-victimization and cyberbullying among adolescents in a Chinese school sample. Child Abuse & Neglect, 77, 180–187. https://doi.org/10.1016/j.chiabu.2018.01.015
13.
ChengQ.ShiC.YanC.RenZ.ChanS. H.-W.XiongS.ZhangT.ZhengH. (2022). Sequential multiple mediation of cognitive fusion and experiential avoidance in the relationship between rumination and social anxiety among Chinese adolescents. Anxiety, Stress, & Coping, 35(3), 354–364. https://doi.org/10.1080/10615806.2021.1955864
14.
ChristinaS.MagsonN. R.KakarV.RapeeR. M. (2021). The bidirectional relationships between peer victimization and internalizing problems in school-aged children: An updated systematic review and meta-analysis. Clinical Psychology Review, 85, 101979. https://doi.org/10.1016/j.cpr.2021.101979
15.
ChuX. W.FanC. Y. (2017). Revision of the revised cyberbullying inventory among junior high school students. Chinese Journal of Clinical Psychology, 25(6), 1031–1034. https://doi.org/10.16128/j.cnki.1005-3611.2017.06.008
16.
ChuX.-W.FanC.-Y.LiuQ.-Q.ZhouZ.-K. (2018). Cyberbullying victimization and symptoms of depression and anxiety among Chinese adolescents: Examining hopelessness as a mediator and self-compassion as a moderator. Computers in Human Behavior, 86, 377–386. https://doi.org/10.1016/j.chb.2018.04.039
17.
ChuX.-W.FanC.-Y.LiuQ.-Q.ZhouZ.-K. (2019). Rumination mediates and moderates the relationship between bullying victimization and depressive symptoms in Chinese early adolescents. Child Indicators Research, 12(5), 1549–1566. https://doi.org/10.1007/s12187-018-9596-6
18.
ClaussK.BardeenJ. R. (2022). The interactive effect of mental contamination and cognitive fusion on anxiety. Journal of Clinical Psychology, 78(4), 517–525. https://doi.org/10.1002/jclp.23224
19.
ColeD. A.ZelkowitzR. L.NickE.MartinN. C.RoederK. M.Sinclair-McBrideK.SpinelliT. (2016). Longitudinal and incremental relation of cybervictimization to negative self-cognitions and depressive symptoms in young adolescents. Journal of Abnormal Child Psychology, 44(7), 1321–1332. https://doi.org/10.1007/s10802-015-0123-7
20.
CooksonC.LuzonO.NewlandJ.KingstonJ. (2020). Examining the role of cognitive fusion and experiential avoidance in predicting anxiety and depression. Psychology and Psychotherapy: Theory, Research and Practice, 93(3), 456–473. https://doi.org/10.1111/papt.12233
21.
EvangelioC.Rodríguez-GonzálezP.Fernández-RíoJ.Gonzalez-VilloraS. (2022). Cyberbullying in elementary and middle school students: A systematic review. Computers & Education, 176, 104356. https://doi.org/10.1016/j.compedu.2021.104356
22.
FangJ.WangX.WenZ.HuangJ. (2020). Cybervictimization and loneliness among Chinese college students: A moderated mediation model of rumination and online social support. Children and Youth Services Review, 115, 105085. https://doi.org/10.1016/j.childyouth.2020.105085
23.
FaustinoB. (2021). Transdiagnostic perspective on psychological inflexibility and emotional dysregulation. Behavioural and Cognitive Psychotherapy, 49(2), 233–246. https://doi.org/10.1017/S1352465820000600
24.
FiorilloD.PapaA.FolletteV. M. (2013). The relationship between child physical abuse and victimization in dating relationships: The role of experiential avoidance. Psychological Trauma-Theory Research Practice and Policy, 5(6), 562–569. https://doi.org/10.1037/a0030968
25.
FisherB. W.GardellaJ. H.Teurbe-TolonA. R. (2016). Peer cybervictimization among adolescents and the associated internalizing and externalizing problems: A meta-analysis. Journal of Youth and Adolescence, 45(9), 1727–1743. https://doi.org/10.1007/s10964-016-0541-z
26.
FledderusM.Oude VoshaarM. A. H.Ten KloosterP. M.BohlmeijerE. T. (2012). Further evaluation of the psychometric properties of the acceptance and action questionnaire–II. Psychological Assessment, 24(4), 925–936. https://doi.org/10.1037/a0028200
27.
GhazanfariF.RezaeiM.RezaeiF. (2018). The mediating role of repetitive negative thinking and experiential avoidance on the relationship between childhood trauma and depression. Archives of Psychiatric Nursing, 32(3), 432–438. https://doi.org/10.1016/j.apnu.2017.12.010
28.
GillandersD. T.BolderstonH.BondF. W.DempsterM.FlaxmanP. E.CampbellL.KerrS.TanseyL.NoelP.FerenbachC.MasleyS.RoachL.LloydJ.MayL.ClarkeS.RemingtonB. (2014). The development and initial validation of the Cognitive Fusion Questionnaire. Behavior Therapy, 45(1), 83–101. https://doi.org/10.1016/j.beth.2013.09.001
29.
GratzK. L.BornovalovaM. A.Delany-BrumseyA.NickB.LejuezC. W. (2007). A laboratory-based study of the relationship between childhood abuse and experiential avoidance among inner-city substance users: The role of emotional nonacceptance. Behavior Therapy, 38(3), 256–268. https://doi.org/10.1016/j.beth.2006.08.006
30.
HayesA. F. (2022). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (3rd ed.). The Guilford Press.
31.
HayesS. C.LuomaJ. B.BondF. W.MasudaA.LillisJ. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1–25. https://doi.org/10.1016/j.brat.2005.06.006
32.
HayesS. C.StrosahlK.WilsonK. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press.
33.
HayesS. C.WilsonK. G.GiffordE. V.FolletteV. M.StrosahlK. (1996). Experimental avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152–1168. https://doi.org/10.1037//0022-006x.64.6.1152
34.
HekmatiI.Abdollahpour RanjbarH.EskinM.DrakeC. E.JobsonL. (2023). The moderating role of experiential avoidance on the relationship between cognitive fusion and psychological distress among Iranian students. Current Psychology, 42(2), 1394–1401. https://doi.org/10.1007/s12144-021-01539-4
35.
HuangC.XieJ.OwusuaT.ChenZ.WangJ.QinC.HeQ. (2021). Is psychological flexibility a mediator between perceived stress and general anxiety or depression among suspected patients of the 2019 coronavirus disease (COVID-19)?Personality and Individual Differences, 183, 111132. https://doi.org/10.1016/j.paid.2021.111132
36.
JinY.LiJ.AnJ.WuJ.HeM. (2019). The differential victimization associated with depression and anxiety in cross-cultural perspective: A meta-analysis. Trauma, Violence, & Abuse, 20(4), 560–573. https://doi.org/10.1177/1524838017726426
37.
KashdanT. B.BarriosV.ForsythJ. P.StegerM. F. (2006). Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behaviour Research and Therapy, 44(9), 1301–1320. https://doi.org/10.1016/j.brat.2005.10.003
38.
KowalskiR. M.GiumettiG. W.SchroederA. N.LattannerM. R. (2014). Bullying in the digital age: A critical review and meta-analysis of cyberbullying research among youth. Psychological Bulletin, 140(4), 1073–1137. https://doi.org/10.1037/a0035618
39.
KurzA. S.BethayJ. S.Ladner-GrahamJ. M. (2014). Mediating the relation between workplace stressors and distress in ID support staff: Comparison between the roles of psychological inflexibility and coping styles. Research in Developmental Disabilities, 35(10), 2359–2370. https://doi.org/10.1016/j.ridd.2014.06.003
40.
LandollR. R.La GrecaA. M.LaiB. S.ChanS. F.HergeW. M. (2015). Cyber victimization by peers: Prospective associations with adolescent social anxiety and depressive symptoms. Journal of Adolescence, 42, 77–86. https://doi.org/10.1016/j.adolescence.2015.04.002
41.
LevinM. E.MacLaneC.DaflosS.SeeleyJ. R.HayesS. C.BiglanA.PistorelloJ. (2014). Examining psychological inflexibility as a transdiagnostic process across psychological disorders. Journal of Contextual Behavioral Science, 3(3), 155–163. https://doi.org/10.1016/j.jcbs.2014.06.003
42.
LiT.NahC. T.FengF. (2018b). Community violence exposure, experiential avoidance and depression in Chinese adolescents. International Journal of Mental Health Promotion, 20(2), 67–74. https://doi.org/10.32604/IJMHP.2018.010839
43.
LiY.LiD.LiX.ZhouY.SunW.WangY.LiJ. (2018a). Cyber victimization and adolescent depression: The mediating role of psychological insecurity and the moderating role of perceived social support. Children and Youth Services Review, 94, 10–19. https://doi.org/10.1016/j.childyouth.2018.09.027
44.
MerwinR. M.Zachary RosenthalM.CoffeyK. A. (2009). Experiential avoidance mediates the relationship between sexual victimization and psychological symptoms: Replicating findings with an ethnically diverse sample. Cognitive Therapy and Research, 33(5), 537–542. https://doi.org/10.1007/s10608-008-9225-7
45.
O’brienR. M. (2007). A caution regarding rules of thumb for variance inflation factors. Quality & Quantity, 41(5), 673–690. https://doi.org/10.1007/s11135-006-9018-6
46.
PolusnyM. A.RosenthalM. Z.AbanI.FolletteV. M. (2004). Experiential avoidance as a mediator of the effects of adolescent sexual victimization on negative adult outcomes. Violence and Victims, 19(1), 109–120. https://doi.org/10.1891/vivi.19.1.109.33238
47.
RanjbarH. A.AbdulcebbarA.YilmazE.KantarciL.AltintasS.EskinM.Altan-AtalayA. (2022). Deviation from balanced time perspective and psychological distress: The mediating roles of cognitive fusion and experiential avoidance. Current Psychology. https://doi.org/10.1007/s12144-022-03203-x
48.
RochefortC.BaldwinA. S.ChmielewskiM. (2018). Experiential avoidance: An examination of the construct validity of the AAQ-II and MEAQ. Behavior Therapy, 49(3), 435–449. https://doi.org/10.1016/j.beth.2017.08.008
49.
RoggeR. D.DaksJ. S.DublerB. A.SaintK. J. (2019). It’s all about the process: Examining the convergent validity, conceptual coverage, unique predictive validity, and clinical utility of ACT process measures. Journal of Contextual Behavioral Science, 14, 90–102. https://doi.org/10.1016/j.jcbs.2019.10.001
50.
ShapkaJ. D.MaghsoudiR. (2017). Examining the validity and reliability of the cyber-aggression and cyber-victimization scale. Computers in Human Behavior, 69, 10–17. https://doi.org/10.1016/j.chb.2016.12.015
SlonjeR.SmithP. K.FrisénA. (2013). The nature of cyberbullying, and strategies for prevention. Computers in Human Behavior, 29(1), 26–32. https://doi.org/10.1016/j.chb.2012.05.024
53.
SpinhovenP.DrostJ.de RooijM.van HemertA. M.PenninxB. W. J. H. (2016). Is experiential avoidance a mediating, moderating, independent, overlapping, or proxy risk factor in the onset, relapse and maintenance of depressive disorders?Cognitive Therapy and Research, 40(2), 150–163. https://doi.org/10.1007/s10608-015-9747-8
54.
StruijsS. Y.de JongP. J.JeronimusB. F.van der DoesW.RieseH.SpinhovenP. (2021). Psychological risk factors and the course of depression and anxiety disorders: A review of 15 years NESDA research. Journal of Affective Disorders, 295, 1347–1359. https://doi.org/10.1016/j.jad.2021.08.086
55.
TennantJ. E.DemarayM. K.CoyleS.MaleckiC. K. (2015). The dangers of the web: Cybervictimization, depression, and social support in college students. Computers in Human Behavior, 50, 348–357. https://doi.org/10.1016/j.chb.2015.04.014
56.
TopcuÇ.Erdur-BakerÖ. (2010). The revised cyber bullying inventory (RCBI): Validity and reliability studies. Procedia - Social and Behavioral Sciences, 5, 660–664. https://doi.org/10.1016/j.sbspro.2010.07.161
57.
TranH. G. N.ThaiT. T.DangN. T. T.VoD. K.DuongM. H. T. (2021). Cyber-victimization and its effect on depression in adolescents: A systematic review and meta-analysis. Trauma, Violence, & Abuse, 152483802110505. https://doi.org/10.1177/15248380211050597
58.
TrindadeI. A.Marta SimõesJ.FerreiraC.Pinto GouveiaJ. (2018). Chronic illness‐related cognitive fusion explains the impact of body dissatisfaction and shame on depression symptoms in breast cancer patients. Clinical Psychology & Psychotherapy, 25(6), 886–893. https://doi.org/10.1002/cpp.2323
59.
TrompeterN.BusseyK.FitzpatrickS. (2018). Cyber victimization and internalizing difficulties: The mediating roles of coping self-efficacy and emotion dysregulation. Journal of Abnormal Child Psychology, 46(5), 1129–1139. https://doi.org/10.1007/s10802-017-0378-2
60.
TsitsikaA.JanikianM.WojcikS.MakarukK.TzavelaE.TzavaraC.GreydanusD.MerrickJ.RichardsonC. (2015). Cyberbullying victimization prevalence and associations with internalizing and externalizing problems among adolescents in six European countries. Computers in Human Behavior, 51, 1–7. https://doi.org/10.1016/j.chb.2015.04.048
61.
TyndallI.WaldeckD.PancaniL.WhelanR.RocheB.DawsonD. L. (2019). The Acceptance and Action Questionnaire-II (AAQ-II) as a measure of experiential avoidance: Concerns over discriminant validity. Journal of Contextual Behavioral Science, 12, 278–284. https://doi.org/10.1016/j.jcbs.2018.09.005
62.
TyndallI.WaldeckD.RivaP.WesselmannE. D.PancaniL. (2018). Psychological flexibility and ostracism: Experiential avoidance rather than cognitive fusion moderates distress from perceived ostracism over time. Journal of Contextual Behavioral Science, 7, 72–80. https://doi.org/10.1016/j.jcbs.2018.02.001
63.
ValvanoA.FloydR. M.Penwell-WainesL.SteplemanL.LewisK.HouseA. (2016). The relationship between cognitive fusion, stigma, and well-being in people with multiple sclerosis. Journal of Contextual Behavioral Science, 5(4), 266–270. https://doi.org/10.1016/j.jcbs.2016.07.003
64.
WangC.La SalleT.WuC.DoK. A.SullivanK. E. (2018). School climate and parental involvement buffer the risk of peer victimization on suicidal thoughts and behaviors among Asian American middle school students. Asian American Journal of Psychology, 9(4), 296–307. https://doi.org/10.1037/aap0000138
WolgastM. (2014). What does the Acceptance and Action Questionnaire (AAQ-II) really measure?Behavior Therapy, 45(6), 831–839. https://doi.org/10.1016/j.beth.2014.07.002
67.
WrightM. F. (2015). Cyber victimization and adjustment difficulties: The mediation of Chinese and American adolescents’ digital technology usage. Cyberpsychology-Journal of Psychosocial Research on Cyberspace, 9(1), 7. https://doi.org/10.5817/CP2015-1-7
68.
WrightM. F.WachsS. (2019). Adolescents’ psychological consequences and cyber victimization: The moderation of school-belongingness and ethnicity. International Journal of Environmental Research and Public Health, 16(14), 2493. https://doi.org/10.3390/ijerph16142493
69.
YangW.LiuS.ZhouJ.PengF.LiuX.LiL.YangC.LiuH.YiJ. (2014). Reliability and validity of Chinese version of the beck depression inventory-ii in Chinese adolescents. Chinese Journal of Clinical Psychology, 22(02), 240–245.
70.
YelaJ. R.CregoA.BuzJ.Sánchez ZaballosE.Gómez MartínezM. Á. (2021). Reductions in experiential avoidance explain changes in anxiety, depression and well‐being after a mindfulness and self‐compassion (MSC) training. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12375
71.
ZhangC.-Q.ZhangR.LuY.LiuH.KongS.BakerJ. S.ZhangH. (2021). Occupational stressors, mental health, and sleep difficulty among nurses during the COVID-19 pandemic: The mediating roles of cognitive fusion and cognitive reappraisal. Journal of Contextual Behavioral Science, 19, 64–71. https://doi.org/10.1016/j.jcbs.2020.12.004
72.
ZhangW.JiY.LiX.GuoH.ZhuZ. (2014). Reliability and validity of the Chinese version of the cognitive fusion questionnaire. Chinese Mental Health Journal, 28(1), 40–44.
73.
ZucchelliF.WhiteP.WilliamsonH. (2020). Experiential avoidance and cognitive fusion mediate the relationship between body evaluation and unhelpful body image coping strategies in individuals with visible differences. Body Image, 32, 121–127. https://doi.org/10.1016/j.bodyim.2019.12.002
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