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Background <p>The Hexaflex model, a core theoretical framework of Acceptance and Commitment Therapy, comprises six components that foster psychological flexibility—present-moment awareness, defusion, self-as-context, acceptance, contact with values, and committed action—each with an opposing factor which is indicative of more inflexible responses. Previous research has examined unique associations among these variables using a complex systems approach. However, it remains unclear how patterns of activation unfold within these systems for military veterans.</p> Methods <p>Using Directed Acyclic Graphs, estimated with the PC stable algorithm, in a sample of U.S. military veterans (<i>N</i> = 283), the current study aimed to identify potential pathways between key components of the Hexaflex model in veterans at risk for developing mental health complaints. We conducted separate analyses for components of flexibility and inflexibility. </p> Results <p>The Directed Acyclic Graphs highlight committed action and acceptance as central drivers of psychological flexibility, while cognitive fusion appears to initiate cascades of inflexibility through self-as-content and inaction, ultimately contributing to experiential avoidance, diminished present-moment awareness, and lack of contact with values.</p> Conclusions <p>These findings suggest plausible conditional dependency pathways among components of psychological flexibility and inflexibility, which may inform theory and generate hypotheses for future longitudinal and experimental research.</p>

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Mapping Psychological (In)Flexibility in U.S. Military Veterans: A Directed Acyclic Graph Approach to the Hexaflex Model

  • 期刊论文

  • 发表日期：

    2026年7月20日

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  • Maarten Sanders,
  • Ana M. Pacheco,
  • Ernst H. W. Koster,
  • Dustin A. Seidler,
  • Chad E. Drake,
  • Kristof Hoorelbeke

摘要

Background

The Hexaflex model, a core theoretical framework of Acceptance and Commitment Therapy, comprises six components that foster psychological flexibility—present-moment awareness, defusion, self-as-context, acceptance, contact with values, and committed action—each with an opposing factor which is indicative of more inflexible responses. Previous research has examined unique associations among these variables using a complex systems approach. However, it remains unclear how patterns of activation unfold within these systems for military veterans.

Methods

Using Directed Acyclic Graphs, estimated with the PC stable algorithm, in a sample of U.S. military veterans (N = 283), the current study aimed to identify potential pathways between key components of the Hexaflex model in veterans at risk for developing mental health complaints. We conducted separate analyses for components of flexibility and inflexibility.

Results

The Directed Acyclic Graphs highlight committed action and acceptance as central drivers of psychological flexibility, while cognitive fusion appears to initiate cascades of inflexibility through self-as-content and inaction, ultimately contributing to experiential avoidance, diminished present-moment awareness, and lack of contact with values.

Conclusions

These findings suggest plausible conditional dependency pathways among components of psychological flexibility and inflexibility, which may inform theory and generate hypotheses for future longitudinal and experimental research.