Psychological inflexibility and resilience in anxiety: insights from machine-learning and robust mediation-based models

AI Summary

Psychological inflexibility shows robust positive direct associations with GAD, anxiety, and stress, indicating it substantially predicts anxiety-related symptom severity.
Resilience dimensions perception of self and planned future emerged as primary predictors and mediators of anxiety-related symptoms in machine learning models.
Findings suggest interventions targeting psychological inflexibility together with resilience enhancement could foster healthier coping and reduce anxiety-related symptoms.

AI Summary

INTRODUCTION: Psychological inflexibility (PI) has been associated with anxiety symptoms, while resilience serves as a protective factor; however, their roles and interrelationship remain poorly understood. METHODS: From April to July 2021, an online protocol employing self-reported measures assessed PI (Acceptance and Action Questionnaire), resilience dimensions (Resilience Scale for Adults), and anxiety-related symptoms (Generalized Anxiety Disorder (GAD) Scale; Depression, Anxiety, and Stress Scales). RESULTS: In a sample of 313 adults (72.20% females; 39.29 ± 11.81 years), Random Forest analysis indicated PI and the resilience dimensions perception of self (R-PS) and planned future (R-PF) as the strongest predictors of anxiety-related symptoms.

Basic summary

Front Psychiatry. 2026 May 18;17:1769001. doi: 10.3389/fpsyt.2026.1769001. eCollection 2026.

ABSTRACT

INTRODUCTION: Psychological inflexibility (PI) has been associated with anxiety symptoms, while resilience serves as a protective factor; however, their roles and interrelationship remain poorly understood. We investigated the role of PI on anxiety-related symptoms while assessing the mediating role of resilience and testing the moderating effect of sex and psychiatric history.

METHODS: From April to July 2021, an online protocol employing self-reported measures assessed PI (Acceptance and Action Questionnaire), resilience dimensions (Resilience Scale for Adults), and anxiety-related symptoms (Generalized Anxiety Disorder (GAD) Scale; Depression, Anxiety, and Stress Scales). A model generation approach, using machine-learning and robust mediation-based models, was applied to investigate the relationships between these constructs.

RESULTS: In a sample of 313 adults (72.20% females; 39.29 ± 11.81 years), Random Forest analysis indicated PI and the resilience dimensions perception of self (R-PS) and planned future (R-PF) as the strongest predictors of anxiety-related symptoms. PI showed a positive direct association with GAD, anxiety, and stress (respectively β = 0.28, β = 0.07, β = 0.20, p ≤ 0.001). Significant indirect associations emerged: PI-Stress regarding R-PS (β = 0.08, p = 0.004), PI-Anxiety regarding R-PF (β = 0.03; p = 0.03), PI-GAD (β = 0.08, p = 0.001) and PI-Stress (β = 0.11, p < 0.001) regarding R-PS and R-PF together.

DISCUSSION: These findings highlight the importance of PI and resilience as interconnected processes underlying mental health outcomes. Additionally, they suggest that psychological intervention programs targeting PI, along with resilience, could foster healthier strategies for coping with anxiety-related symptoms.

PMID:42232998 | PMC:PMC13223371 | DOI:10.3389/fpsyt.2026.1769001

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