Journal of Contextual Behavioral Science ()

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Journal of Contextual Behavioral Science

journal homepage: www.elsevier.com/locate/jcbs

Empirical Research

A pilot of an acceptance-based risk reduction program for relational

aggression for adolescents$
Christina Theodore-Oklota n, Susan M. Orsillo, Jonathan K. Lee 1, Peter M. Vernig
Suffolk University, Department of Psychology, 41 Temple Street, Boston, MA 02114, United States

art ic l e i nf o

a b s t r a c t

Article history:
Received 7 October 2012
Received in revised form
6 February 2014
Accepted 12 March 2014

Psychosocial consequences of relational aggression have garnered signicant attention. Although most
adolescents are targets of relational aggression at some point, only a sub-group experience signicant
psychological distress and impaired functioning, with research linking experiential avoidance to
negative outcomes. The present study sought to develop and pilot a school-based risk-reduction
program informed by acceptance-based behavioral theory aimed to reduce experiential avoidance and
increase acceptance- and action-based coping to reduce psychosocial distress. Eight 7th grade classrooms comprising of 210 participants with a mean age of 12.45 were group-randomized to either
immediate or waitlist condition. Multiple regressions were conducted on baseline and three-month
follow-up measures of peer victimization, peer aggression, experiential avoidance, psychopathology, and
coping style. Baseline experiential avoidance was signicantly associated both the extent to which a
student engaged in, and was the victim of, both relational and physical aggression. The program group
engaged in more problem-solving coping compared to the waitlist group at follow-up. Change in
experiential avoidance predicted negative outcomes at follow-up across domains regardless of group
assignment. Implications and recommendations for future studies are discussed.
& 2014 Association for Contextual Behavioral Science. Published by Elsevier Inc. All rights reserved.

Keywords:
Peer victimization
Adolescents
Experiential avoidance
Coping

1. Introduction
Peer aggression has become a signicant concern over the last
decade (Crick, Casas, & Nelson, 2002; Stassen Berger, 2007), with
increasing attention given to social or relational forms. Relational
aggression involves harming an individual through the manipulation of relationships and overall social status (Crick et al., 2002;
Galen & Underwood, 1997), using behavioral (e.g., exclusion),
verbal (e.g., rumors), or cyber (e.g., social networks) means. It is
the most common form of aggression reported by adolescents
(Crick et al., 2002; Williams & Guerra, 2007) and tends to be
moderatly stable during this time (Zimmer-Gembeck, Geiger, &
Crick, 2005). A national survey of 6th10th graders found prevelance rates of 53.6% for verbal aggression and 51.4% for socal

Funding: This research received no specic grant from any funding agency in
the public, commercial, or not-for-prot sectors.
n
Corresponding author. Present address: Genentech, 1 DNA Way, MS 88,
South San Francisco, CA 94080, United States. Tel.: 1 650 467 3786;
fax: 1 650 225 4093.
E-mail addresses: theodoreoklota.christina@gene.com (C. Theodore-Oklota),
sorsillo@suffolk.edu (S.M. Orsillo), jonathan.lee@suffolk.edu (J.K. Lee),
peter.vernig@suffolk.edu (P.M. Vernig).
1
Present address: The Family Institute at Northwestern University, 618 Library
Place, Evanston, IL 60201, United States.

aggression compared to 20.8% for physical aggression (Wang,

Iannotti, & Nansel, 2009). Being the victim of relational aggression
has been shown to be associated with signicant academic
difculties and psychosocial distress well into adulthood (e.g.,
Crick & Grotpeter, 1995; Grills & Ollendick, 2002; Hanish & Guerra,
2002; Prinstein, Boergers, & Vernberg, 2001; Taylor, Sullivan, &
Kliewer, 2013).
Although there is evidence of relational aggression among
preschoolers (Crick, Casas, & Ku, 1999; Crick et al., 2001; Ostrov,
2008), the prevalence seems to increase during late childhood/
early adolescence (Olweus, 1994; Werner & Nixon, 2005; Williams
& Guerra, 2007). During middle school years, children gain a better
understanding of the value and power of social situations and how
to use relationships as a more subtle tool to achieve and maintain
social inuence (Crick et al., 2001; Leadbeater, Boone, Sangster, &
Mathieson, 2006; Roecker Phelps, 2001; Underwood, 2003). Students who engage in relational aggression often view themselves
as strong, in charge, and accepted by peers (Salmivalli,
Lappalainen, & Lagerspetz, 1998) and are rated by others as
popular (Leadbeater et al., 2006) contributing to signicant
inuence within social groups (Cillessen & Mayeux, 2004;
Puckett, Aikins, & Cillessen, 2008). In contrast, during adolescence,
physical aggression is viewed as less socially acceptable, with
fewer benets (Cillessen & Mayeux, 2004; Leadbeater et al., 2006)

http://dx.doi.org/10.1016/j.jcbs.2014.03.001
2212-1447/& 2014 Association for Contextual Behavioral Science. Published by Elsevier Inc. All rights reserved.

Please cite this article as: Theodore-Oklota, C., et al. A pilot of an acceptance-based risk reduction program for relational aggression
for adolescents. Journal of Contextual Behavioral Science (2014), http://dx.doi.org/10.1016/j.jcbs.2014.03.001i

C. Theodore-Oklota et al. / Journal of Contextual Behavioral Science ()

and greater social and legal costs (Cillessen & Mayeux, 2004; De
Los Reyes & Prinstein, 2004). Thus, relational aggression may be
viewed as an acceptable outlet to express the anger and frustration
towards others that adolescents continue to experience as they
grow older (Prinstein et al., 2001), and as a tool to increase social
status (Leadbeater et al., 2006; Salmivalli et al., 1998).
Historically, relational aggression was viewed primarily as a
female behavior; however, research has produced mixed ndings
(e.g., Coyne, Archer, & Eslea, 2006; Crick & Grotpeter, 1996;
Paquette & Underwood, 1999). A meta-analysis found that
although boys were more physically aggressive, there were negligible gender differences for relational aggression across various
assessment methods, age, and ethnicity (Card, Stucky, Sawalani, &
Little, 2008). Nelson, Mitchell, and Yang (2008) found there were
gender differences in the forms of relational aggression used; girls
were more likely to use covert forms of relational aggression (e.g.,
gossiping, spreading rumors) whereas boys utilized more overt
tactics (e.g., direct name calling, mocking masculinity). Further, the
social rewards of being relationally aggressive are present for both
genders (Hoff, Reese-Weber, Joel Schneider, & Stagg, 2009; Puckett
et al., 2008). Regardless, the evidence indicates that both boys and
girls suffer psychosocial consequences (Merrell, Buchanan, & Tran,
2006; Nishina, Juvonen, & Witkow, 2005), highlighting the need to
address relational aggression across gender.
Although most children are exposed to peer aggression at some
point, only a minority experience repeated targeting and/or longterm negative consequences (Hoover, Oliver, & Hazler, 1992;
Kochenderfer-Ladd & Skinner, 2002; Ladd & Ladd, 2001). Research
suggests that coping style may be an important moderator.
Specically, styles of coping that involve experiential avoidance
in response to relational aggression, involving denial or minimization of the impact of the internal experience aggression, appears to
be a risk factor for both future victimization and poorer outcomes.
Kochenderfer-Ladd and Skinner (2002) found that even infrequent
victims of aggression suffered negative outcomes when they used
strategies that involved avoidance. A second study expanded on
this research, nding those who attempted to avoid aggression
through either cognitive distancing or ignoring the aggression
were at greater risk for revictimization and the development of
internalizing disorders (Kochenderfer-Ladd, 2004). Lodge and
Feldman (2007) found the use of avoidant strategies in response
to appearance specic relational aggression mediated the relationship with low self-esteem. This reduction in self-esteem could lead
to greater victimization as research has found a circular relationship between relational aggression and low self-esteem where the
internalization of aggressive statements further reduces selfesteem leading to repeated victimization (Crick & Bigbee, 1998).
Further, the use of avoidant strategies by adolescents to cope with
general stressors has been shown to be associated with depressive
symptoms, which increases the risk for being the target of
relational aggression (Seiffge-Krenke & Klessinger, 2000).
Interestingly, the use of avoidant coping strategies to deal with
interpersonal aggression may increase with age, (Roecker Phelps,
2001) suggesting these strategies may be particularly prevalent
among adolescents. This may explain why in middle school-aged
adolescents, high levels of relational victimization has been
associated with substance use, which has been conceptualized as
a form of coping through experiential avoidance (Sullivan, Farrell,
& Kliewer, 2006).
Although experiential avoidance strategies are ineffective in
reducing peer victimization and its associated consequences,
denying or minimizing the occurrence or impact of relational
aggression can be associated with an immediate reduction in
distress which negatively reinforces experiential avoidant behavior (Mahady Wilton, Craig, & Pepler, 2000). Victims report that
trying to suppress their distress or acting tough helps them to

feel stronger (Owens, Slee, & Shute, 2000) and parents and
teachers often recommend avoidant responses (i.e., don't let it
bother you, ignore it), despite the long-term ineffectiveness of
this strategy (Roecker Phelps, 2001).
Taken together, these ndings suggest that individuals who are
signicantly distressed by relational aggression may engage in
strategies to cope with the aggression though avoidance which
despite the perceived reduction in distress, may actually increase
their risk for future victimization and poor psychosocial outcomes.
These ndings are consistent with recent theories linking attempts
to avoid internal experiences with a broad array of psychological
problems (e.g., Bieling et al., 2012; Chiesa & Serretti, 2011; Hayes
Hayes, Wilson, Gifford, Follette, & Strosahl, 1996), as well as
experimental research demonstrating the paradoxically negative
effects of suppression of thoughts (e.g., Abramowitz, Tolin, &
Street, 2001) and emotions (e.g., Gross & Levenson, 1997). This
suggests a program aimed at teaching individuals to understand
their emotional responses to relational aggression, targeting the
automatic and habitual use of experiential avoidance, and
encouraging active problem-solving might be effective in reducing
the negative outcomes of relational aggression.
As a result of the growing attention given to relational aggression, many schools are augmenting their anti-bullying policies
by providing school-based programs aimed at reducing peer
aggression and there has been an increase in the number of
interventions targeting relational aggression (see review by Leff,
Waasdorp, & Crick, 2010). However, most are focused on the
aggressors and little attention is paid to the victims or how to
cope with aggression. In fact, we were only able to nd one
intervention that focused exclusively on victims of relational
aggression, the Walk away, Ignore, Talk, and Seek help program
[W.I.T.S.], a large scale community-based program designed for
children in kindergarten through third grade (Leadbeater,
Hoglund, & Woods, 2003). Many have argued that school-based
interventions need to empower the targets of aggression by
teaching them the skills they need to respond to challenging
social behaviors and adaptively cope with the consequences of
relational aggression rather than focusing solely on changing the
behavior of the perpetrator (Espelage & Swearer, 2003; Owens,
Slee, & Shute, 2001; Salmivalli, Kaukiainen, & Voeten, 2005;
Smokowski & Kopasz, 2005). Although aiming to reduce the
frequency of relational aggression is important, given its widespread prevalence and covert nature, programs aimed at building
adaptive coping skills among potential victims of aggression are
also needed (Salmivalli et al., 2005).
Additionally, several studies have found an association between
relational victimization and relational aggression (Crick et al.,
1999; Sullivan et al., 2006), suggesting that some victims may
resort to aggression to reestablish their own social position (Yeung
& Leadbeater, 2007) and there may be a false dichotomy between
the aggressors and victims of relational aggression (Casey-Cannon,
Hayward, & Gowen, 2001; Crick et al., 1999; Owens et al., 2000;
Yeung & Leadbeater, 2007). This has caused some to rightfully
suggest the best way to prevent relational victimization is through
empirically and conceptually based programs that address both
victims and aggressors (Yoon, Barton, & Taiariol, 2004).
The aim of the current study was to develop and pilot a schoolbased program aimed at decreasing the negative consequences
associated with relational aggression. Given the hypothesized role
of experiential avoidance in increasing negative outcomes, we
developed an acceptance-based behavioral program aimed at
helping students to understand their emotional responses to
relational challenges, decrease their automatic and habitual use
of experiential avoidance, and engage in active problem-solving.
Acceptance-based approaches have demonstrated efcacy across a
range of problem areas (e.g., Ruiz, 2010) and there have been

Please cite this article as: Theodore-Oklota, C., et al. A pilot of an acceptance-based risk reduction program for relational aggression
for adolescents. Journal of Contextual Behavioral Science (2014), http://dx.doi.org/10.1016/j.jcbs.2014.03.001i

C. Theodore-Oklota et al. / Journal of Contextual Behavioral Science ()

successful adaptations of mindfulness and acceptance techniques

in targeting child and adolescent concerns (e.g., Coyne, McHugh, &
Martinez, 2011). We endeavored to address some of the limitations
of previous studies and gaps in current interventions highlighted
by Leff et al. (2010) by offering a brief program to an entire grade
of middle school students (male and female, regardless of aggressor or victimization status) as part of the regular curriculum and
assessing outcome at 3-month follow-up. The program was
developed by the authors of the current paper and informed by
acceptance and commitment therapy (ACT) as well as other
acceptance-based behavioral therapies (ABBTs) (e.g., Roemer,
Orsillo, & Salters-Pedneault, 2008).

2.2.2. Revised Peer Experiences Questionnaire Self-Report (PEQ-R;

Prinstein et al., 2001)
The PEQ-R is a self-report measure designed to measure how
frequently individuals engage in and receive physical and relationally aggressive and prosocial acts on a 5-point Likert-type scale
(1 never, 5 a few times a week). Items are summed with higher
scores indicating more occurrences. In the current study, the PEQR was used to assess relational aggression (10 items) and physical
aggression (three items) as the SEQ only assesses relational and
physical victimization. Alpha coefcients at time one were .84 for
relational aggression and .82 for physical aggression. At time two
alphas were .86 for relational aggression and .84 for physical
aggression.

2. Method

2.2.3. Responses to Stress Questionnaire (RSQ; Connor-Smith,

Compas, Wadsworth, Thomsen, & Saltzman, 2000)
To measure the use of problem-solving coping we used the
RSQ, a 57-item youth self-report questionnaire that measures
types of coping to a specic stressful situation. Participants
respond to the items on a 4-point Likert-type scale (1 not at all,
4 a lot) to indicate the frequency with which coping responses
were used. The RSQ is designed to assess a broad range of
responses to stress (Connor-Smith et al., 2000) and have demonstrated good reliability and validity as well as excellent to
adequate internal consistency, testretest reliability, and convergent and discriminate validity when compared to other measures
of coping and internal distress (Connor-Smith et al., 2000). For the
present study we used only the problem-solving subscale which
consisted of three items (I try to think of different ways to change
the problem or x the situation; I ask other people for help or for
ideas about how to make the problem better; I do something to
try to x the problem or take action to change things) as it was
the primary construct of interest and there are limited psychometrically validated measures of coping particularly to a specic
stressor in this age group. Written instructions directed participants to think specically about how they coped with the
problems they have had with friends or peers in the last six
months. A similar form was used at the follow-up assessment with
the instructions directing the participants to think about the last
three months. Internal consistency was moderate at time one .67
and time two .66.

2.1. Participants
Participants were 210 seventh grade students with a mean age
of 12.45 years (SD .51) who were members of eight classrooms
(divided into 2 teaching teams of 4 classrooms each) at a suburban
New England middle school. Forty-four percent of the sample
were girls and most of the participants self-identied as White
(67.6%). Although 24.3% did not report their ethnicity, no other
racial/ethnic category was endorsed by more than 1.4% of the
sample. Information about the program was delivered to parents
through iers, the school's web portal and at the monthly Parent
Teacher Organization (PTO) meeting where a description of the
program as well as randomization procedures (i.e., the possibility
that students could receive the program immediately or be waitlisted and receive the program in 3 months) were provided to the
parents. Consistent with the school's policies on health and wellness programming, students participated in the program unless
parents' indicated a lack of consent. Three parents permitted their
children to participate in the program but refused the assessment
phase of the study. All participants completed an assent form
explaining the nature of the program prior to data collection
and at this time the randomization process was explained to
participants.
2.2. Measures
2.2.1. Revised-Social Experiences Questionnaire Self-Report (SEQ;
Crick & Grotpeter, 1996)
The SEQ is a self-report scale specically developed to assess on
a 5-point Likert-type scale (1 never, 5 all the time) the frequency
that participants have been the recipient of prosocial, physically
aggressive, and relationally aggressive behaviors from peers (Crick
& Grotpeter, 1996). Items are summed with higher scores indicating greater victimization. In the current study, only the relational
victimization scale (11 items) was used. We opted to use the SEQ
to measure the construct of relational victimization, as, at the time
of the program, it was the most comprehensive measure to
capture the diverse experience of relational victimization. In an
attempt to capture overt behaviors, Paquette and Underwood
(1999) added two items (eye rolling, making faces) that were
found to correlate strongly with other items on the relational
aggression subscale and may better tap into the specic ways in
which boy experience relational aggression which we included in
the version we used. Further based on the literature, we wrote and
included two additional items that were not being captured yet
are a frequently reported occurrence by most children and
adolescents (i.e., making fun of gender identity and being taunted
on the internet). Alpha coefcients for the whole measure with
included items at time one were .87 and at time two .90.

2.2.4. Avoidance and Fusion Questionnaire for Youth (AFQ-Y; Greco,

Lambert, & Baer, 2008)
The AFQ-Y is a 17-item self-report measure designed to assess
experiential avoidance and behavioral ineffectiveness in the presence of a stressor. In contrast to the RSQ, which looks at the way
an individual copes with a specically indicated stressor such as
relational aggression, the AFQ-Y was used to assess a more general
style of coping to various stressors. Participants rate how true each
statement is on a 5-point Likert-type scale (0 not at all true,
4 very true). Convergent validity for the AFQ-Y has been established (Greco et al., 2008). In the present study, internal consistency was high with alphas of .86 and .91 at time one and time two
respectively.
2.2.5. Child Behavior Checklist Youth Self-Report (YSR; Achenbach,
1991)
The YSR is a checklist of behavioral and emotional functioning
completed by adolescents aged 1118. Items are scored as 0 not
true, 1 somewhat/sometimes true, and 2 often/very true. For
the present study, items that asked about self-harm, suicidal
ideation, sexual behaviors, and engagement in illegal activities
were removed from the measure due to the use of passive consent.
Specically, items 2 (I drink alcohol without my parents'

Please cite this article as: Theodore-Oklota, C., et al. A pilot of an acceptance-based risk reduction program for relational aggression
for adolescents. Journal of Contextual Behavioral Science (2014), http://dx.doi.org/10.1016/j.jcbs.2014.03.001i

C. Theodore-Oklota et al. / Journal of Contextual Behavioral Science ()

approval), 18 (I deliberately try to hurt myself), 72 (I set res),

82 (I steal from places other than home), 91 (I think about
killing myself), 96 ( I think about sex too much), 99 (I smoke,
chew, or sniff tobacco), 105 (I use drugs for non medical
purposes), and 110 (I wish I were of the opposite sex) were
removed and the remaining 103 items were administered. We
used the Total Problems Score as an indicator of overall psychological distress. In the present sample alphas were .92 at time one
and .93 at time two.
2.3. Procedure
All participants (all of the eight classrooms) completed an
assessment battery including the SEQ, PEQ-R, YSR, AFQ-Y, and
RSQ-PS administered by doctoral students and research assistants,
during the school day during a 48-min class period. Three months
after the program was delivered all participants completed the
same assessment battery in a similar class period.
Following the assessment, one teaching cohort of four classrooms was randomized to receive the program through a coin ip
(i.e., a pre-established group of four classrooms were randomized
to condition rather than individual participants). The other teaching team of four classrooms was waitlisted to receive the program
following reassessment of all eight classrooms at three months.2
The program was delivered in three sessions that occurred over
the course of two weeks during a 48-minute class period. The
program, designed to be interactive and engaging, involved group
discussions, role-playing, and experiential exercises. To encourage
participation, students had the opportunity to earn tickets for a
drawing to win gift cards at the conclusion of the program.
Each group was lead by two doctoral students who were
trained (during 23, six hour sessions) in the delivery of the
program. Leaders met with the rst author after each session to
troubleshoot any issues that arose.
2.4. Program description3
In session one, participants discussed the positive and negative
aspects of friendships to highlight the social power of relationships. Psychoeducation was provided to increase student awareness of subtle behaviors that characterize relational aggression.
The possible functions of relational aggression were discussed,
with an emphasis on how aggressive acts are sometimes used as a
short-term method of avoiding negative feelings (such as loneliness and insecurity) and increasing positive emotions (such as
feeling included and powerful). Participants also completed a
worksheet that had them reect on the type of friend they wanted
to be and evaluate how consistently they acted in accordance with
their identied friendship values.
Session two focused on an evaluation of the strengths and
weaknesses of different coping strategies. The paradoxical effects
of avoidant coping were demonstrated using a nger trap (pulling
your ngers to try to get free actually tightens the trap). Students
considered how the habitual use of avoidant coping can interfere
with taking effective actions that are consistent with ones
personal values (e.g., holding a secret when mad at a friend).
Mindfully engaging in valued action while taking an accepting
stance toward internal experiences was introduced as an alternative. Participants considered the Passengers on a Bus metaphor adapted from ACT (Hayes, Strosahl, & Wilson, 1999) to
illustrate the choices they have about how to engage with peers.
2
Although the waitlist group was provided with the program after the followup assessment was complete, post-program data was not collected on this group
3
A copy of the manual is available through request of the rst author.

Driving a bus on one's chosen path was offered as an analogy for

acting in ways that are consistent with one's personal values about
peer relationships. Unruly passengers on a bus (e.g., doubts, fear,
embarrassment) might pester the driver to change course, but the
driver has the choice about which road to take.
In the nal session, students considered how being open to
experiencing one's emotions might facilitate effective, valuesdriven coping in response to peer conict. Recreating a talk show
atmosphere, participants helped George problem-solve ways to
effectively use his emotions rather than avoid them when evaluating the negative treatment he was receiving by his friends. To
demonstrate how avoidant coping encourages actions that are
inconsistent with personally-held values and paradoxically
increases distress, volunteers role-played a girl who struggled
with the hurt feelings of being excluded by a friend. Participants
discussed the pros and cons of engaging in retaliation versus
staying consistent with one's personal values with regard to
behavior towards peers. The program concluded with a powerful
activity aimed at demonstrating the benets of effective, valuesconsistent coping (adapted from L. Coyne, personal communication, September 6, 2007). A student was invited to the front of the
classroom to bully the group leader. The leader responded rst
in a passive, avoidant manner, which left the aggressor feeling in
control, the leader ineffectual, and the bystanders amused. Next,
the leader acted in a values consistent manner (i.e., looking the
aggressor in the eye, not being vindictive in retaliation), which
defused the aggressor's power and aligned the audience with the
leader.
Following the completion of the program, participants provided written feedback and were given a project (bus) key chain as
a memento, and a packet of information with further readings and
exercises.

2.5. Data analysis

Descriptive statistics were conducted on all study variables (see
Table 1). Independent t-tests were conducted to examine if there
were any pre-intervention differences between groups and
between gender on the dependent variables: Social Experiences
Questionnaire (SEQ) Relational Victimization subscale (RV) and
Physical Victimization subscale (PV); Peer Experiences Questionnaire (PEQ-R) Relational Aggression subscale (RA) and Physical
Aggression subscale (PA); Child Behavior Checklist Youth
Self-Report (YSR) Total Score; Avoidance and Fusion Questionnaire Youth Report (AFQ-Y); and Response to Stress Questionnaire
Problem Solving Scale (RSQ-PS). Identied differences were
considered covariates in the subsequent analysis and controlled
for as such. Multicollinearity was examined across dependent
variables.
To evaluate the potential relationship between experiential
avoidance and relational aggression, we examined baseline correlations between these variables. To investigate the efcacy of the
program in decreasing relational aggression and its associated
features a series of hierarchical regression analyses were conducted to examine the potential main effects of group (program vs.
waitlist) on relational victimization, aggression, psychological
functioning, and problem-solving coping. Finally, we examined
whether change in experiential avoidance (using a residualized
gain score) as a function of treatment was related to program
outcomes. Because individual students were not randomly assigned to
condition, we used multiple regression rather than repeated
measures analyses in order to avoid making assumptions about
the pattern of within member covariance matrices (Murray, 1998).
Scores were converted to z-scores in the regressions for ease of
interpretation.

Please cite this article as: Theodore-Oklota, C., et al. A pilot of an acceptance-based risk reduction program for relational aggression
for adolescents. Journal of Contextual Behavioral Science (2014), http://dx.doi.org/10.1016/j.jcbs.2014.03.001i

C. Theodore-Oklota et al. / Journal of Contextual Behavioral Science ()

Table 1
Pre-program and follow-up means and standard deviation of participants by condition.
Measures

Pre-program

Follow-up

Program

Waitlist

Program

Waitlist

SEQ
Relational victimization
Physical victimization

15.68 (5.52)
5.50 (1.84)

16.48 (5.69)
5.84 (2.32)

15.58 (6.17)
5.78 (2.35)

16.97 (6.41)
6.23 (2.44)

PEQ-R
Physical aggression
Relational aggression

3.26 (.80)
13.82 (3.76)

3.96 (1.96)
14.68 (5.33)

3.52 (1.41)
14.14 (4.38)

4.13 (2.24)
14.77 (6.17)

YSR
Total score

30.76 (20.04)

31.42 (19.27)

31.01 (21.81)

31.92 (22.78)

4.85 (2.25)

4.61 (2.43)

4.65 (2.43)

3.92 (2.40)

13.58 (10.04)

13.58 (10.02)

12.68 (11.59)

13.12 (11.71)

RSQ
Problem solving
AFQ-Y

Note: SEQ-R Social Experiences Questionnaire; PEQ-R Peer Experiences Questionnaire Revised; YSR Child Behavior Checklist Youth Self-Report, Total Score;
RSQ Response to Stress Questionnaire, AFQ-Y Avoidance and Fusion Questionnaire Youth.

Table 2
Program impact and experiential avoidance as a predictor of outcomes at follow-up.
Predictors

Relational victimization (RV)

R2

Step 1
Baseline Outcome Measure
Baseline PEQ-R-PA
Gender (female)
Baseline AFQ-Y

.41nn

Step 2
Baseline Outcome Measure
Baseline PEQ-R-PA
Gender (female)
Baseline AFQ-Y
Group (program)
Change in AFQ-Y

.12nn

Step 3
Baseline Outcome Measure
Baseline PEQ-R-PA
Gender (female)
Baseline AFQ-Y
Group (program)
Change in AFQ-Y
Group  change in AFQ-Y

.00

Relational aggression (RA)

R2

R2

.37nn
.51nn
.23nn
.03
.07

.63nn
.53nn
.14
 .01
 .02

.07nn
.45nn
.19nn
.08
.10
 .01
.36nn

R2

.27nn

.16nn

.50nn
.10
.08
 .04
.05nn

.55nn
.27nn
.08
.06
.02
.42nn
.00

.50nn
.11
.02
-.10
 .01
.27nn
.01

Problem-solving coping (RSQ-PS)

.63nn
.29nn
.01
.01

.50nn
.11
.02
 .01
 .01
.27nn
.00

.45nn
.19nn
.08
.10
 .01
.35nn
.01

Psychological functioning (YSR)

.50nn
.11
.09
-.05
.15n
.17n
.00

.55nn
.28nn
.08
.05
.02
.37nn
.07

.50nn
.10
.09
 .05
.15n
.18
 .02

Note: PEQ-R-PA Peer Experiences Questionnaire Revised, Physical Aggression subscale; YSR Child Behavior Checklist Youth Self-Report, Total Score; AFQ-Y Avoidance
and Fusion Questionnaire Youth Score; RSQ-PS Response to Stress Questionnaire Problem Solving Subscale.
n

po .05.
p o.01.

nn

3. Results
3.1. Pre-intervention group comparison
Independent samples t-test were conducted on the dependent
variables at baseline to compare pre-program group differences.
No signicant differences emerged between those who received
the program (n 105) and the waitlist group (n 105) on preprogram scores of relational victimization (SEQ-RV), physical
victimization (SEQ-PV), relational aggression (PEQ-R-RA), physical
aggression (PEQ-R-PA), psychopathology (YSR), problem-solving
coping (RSQ-PS), or experiential avoidance (AFQ-Y). However,
participants in the waitlist group reported higher scores on the
PEQ-PA suggesting they engaged in more physical aggression
against peers t(106.72) 2.97, p .01. Thus, this variable was used
as a covariate in subsequent analyses.

An additional series of independent samples t-tests were

conducted on the dependent variables at baseline to compare
pre-program gender differences. Boys scored signicantly higher
than girls on the physical aggression (PEQ-R-PA) t(117.72) 2.74,
p .01, and physical victimization (SEQ-PV), t(150.09) 2.10,
p .04. In contrast, girls scored signicantly higher than boys on
problem-solving coping (RSQ-PS), t(169)  4.56, p .00. No other
signicant differences emerged.
3.2. Pre-intervention relationship between experiential avoidance
and aggression
As predicted, baseline experiential avoidance was signicantly
associated with both the extent to which a student engaged in
relational aggression (r .33, po .01) and was the recipient (r .45,
po .01). Baseline experiential avoidance was also signicantly

Please cite this article as: Theodore-Oklota, C., et al. A pilot of an acceptance-based risk reduction program for relational aggression
for adolescents. Journal of Contextual Behavioral Science (2014), http://dx.doi.org/10.1016/j.jcbs.2014.03.001i

C. Theodore-Oklota et al. / Journal of Contextual Behavioral Science ()

associated with both the extent to which a student engaged in

physical aggression (r .26, p o.01) and was the recipient (r .32,
p o.01).
3.3. Impact of program on outcome variables
A series of hierarchical regression analyses were conducted to
examine the potential main effects of group (program vs. waitlist)
on several outcomes at follow-up. In each equation, the following
z-scored variables, viewed as covariates, were entered in the rst
step: baseline measure of the dependent variable (to account for
pre-program functioning), baseline physical aggression (PEQ-R-RPA subscale scores; given group differences at baseline), baseline
experiential avoidance (AFQ-Y; given its demonstrated association
with interpersonal aggression at baseline) and gender. Group
assignment (program or waitlist), and the AFQ-Y residualized gain
score (to determine the impact of change in experiential avoidance
on outcomes) was entered on the third step. In the nal step, we
entered the group by AFQ-Y residualized gain score interaction to
examine whether any potential impact of change in experiential
avoidance on outcomes would be moderated by program participation. Intercorrelations between study variables were all in the
expected directions.
Contrary to predictions, there were no signicant main effects
for group or gender on rates of relational victimization (SEQ-RV),
relational aggression (PEQ-R-RA), or psychopathology (YSR) at
follow-up (see Table 2). However, group membership did predict
use of active problem-solving coping (RSQ-PS) in response to peer
conict over and above the effects of baseline measures of
problem-solving coping (RSQ-PS), physical aggression (PEQ-RPA), gender, baseline experiential avoidance (AFQ-Y), and change
in experiential avoidance (residualized gain score on AFQ-Y;
.15, p .03).
Baseline experiential avoidance was not a signicant predictor
of any of the outcomes over and above the effects of the covariates.
However, change in experiential avoidance from baseline to
follow-up signicantly contributed unique variance in relational
victimization ( .35, p .01), relational aggression ( .27,
p .01), and psychological functioning ( .37, p .01). In contrast,
the unique impact of change in experiential avoidance on
problem-solving coping was not signicant ( .18, p .07) at
follow-up.
Finally, we examined the impact of the program on experiential
avoidance. Contrary to predictions, after controlling for the effects
of baseline experiential avoidance, physical aggression, and gender
on experiential avoidance at follow-up, the impact of the program
was not signicant ( .12, p .81).
4. Discussion
Overall, the program did not signicantly impact the frequency
of relational victimization, relational aggression or psychological
functioning which is consistent with previous studies (see review
by Leff et al., 2010) Although we had hoped the program would
reduce victimization, the primary goal of the program was to
change the ways individuals coped with the ubiquitous experience
of peer aggression. We did nd evidence that the program
impacted problem-solving coping in response to peer conict.
This nding is promising as the use of problem-solving coping in
general compared to the use of avoidant strategies is associated
with better functioning in adolescents (Endler & Parker, 1990). It is
likely that problem-solving skills are easier to learn and implement than acceptance-based strategies such as being mindful of
one's emotional response to conict or connected with one's
personal values about peer relationships. Acceptance-based coping

skills may require more practice particularly before they are

successfully utilized in a high-pressure situation such as an
aggressive interaction. It could be the participants in the program
group were taking the rst step at reducing avoidant coping to
relational aggression by selecting the easiest skill to implement
using problem-solving coping. It is possible that over time changes
in coping style will eventually reduce the frequency of peer
victimization and associated psychological functioning; however,
studies with longer follow-up periods are needed to investigate
this possibility.
Another potential explanation for the ndings is that our
conceptualization is awed and that using acceptance-based
approaches to target experiential avoidance is not the best
approach for reducing relational victimization and its associated
consequences. Since the program was not successful in signicantly reducing experiential avoidance among all participants but
may have impacted some, this conclusion may be premature.
Interestingly, the mean experiential avoidance reported in the
current sample was substantially lower than the mean scores
derived from the normative population of non-clinical 5th to 10th
graders (Greco et al., 2008), which could have made it more
difcult to detect change over time between groups. Further, a
three-session intervention may have been too weak to signicantly target experiential avoidance, particularly given how
strongly these efforts are reinforced both by the immediate
reduction of painful feelings and by societal forces. In contrast, it
may have been easier for participants to learn and implement the
problem-solving skills we offered which do encourage a present
awareness.
However, despite our inability to reduce experiential avoidance
through program participation, our ndings do highlight the
strong association between experiential avoidance and interpersonal aggression. Not only did we nd a correlation between
baseline experiential avoidance and all forms of aggression, we
also demonstrated that changes in experiential avoidance from
baseline to follow-up uniquely contributed to the prediction of
relational victimization, relational aggression, and psychological
functioning. These results are consistent with those reported by
others who found avoidance to be associated with victimization
and distress (Kochenderfer-Ladd & Skinner, 2002; Ladd & Ladd,
2001; Roecker Phelps, 2001). Our ndings add to this body of
research by using a measure that was specically designed to
evaluate at the theoretical construct of experiential avoidance with
middle school participants. The contribution of experiential avoidance to negative outcomes contradicts the message many children
and adolescents receive about how to cope with relational
aggression from adults or through the media, such as to ignore
the aggression, don't let others see that the teasing bothers you or
terminate the relationship. And similar to research that found that
when teachers instructed individuals to use avoidant they
reported experiencing greater distress (Troop-Gordon & Quenette,
2010), our ndings also suggest this message may be putting
individuals at higher risk for repeated victimization and poor
psychosocial outcomes. An important next step is to educate those
who work with children about the detrimental effects of experiential avoidance and encourage the promotion of more active
based coping such as problem solving when dealing with relational aggression.
The nding that experiential avoidance is also predictive of
engagement in relational aggression is intriguing. Engaging in
these strategies may temporarily enhance feelings of social power,
inclusion, and popularity (Guerra, Williams, & Sadek, 2011; Yeung
& Leadbeater, 2007). Similar studies have also found that individuals who were victims of relational aggression who responded
using avoidance, reported engaging in increased peer aggression
(Visconti & Troop-Gordon, 2010). It is possible that some

Please cite this article as: Theodore-Oklota, C., et al. A pilot of an acceptance-based risk reduction program for relational aggression
for adolescents. Journal of Contextual Behavioral Science (2014), http://dx.doi.org/10.1016/j.jcbs.2014.03.001i

C. Theodore-Oklota et al. / Journal of Contextual Behavioral Science ()

aggressors engage in relationally aggressive behavior to avoid their

own painful emotions that arise from peer interactions, which in
essence may make the act of being aggressive a form of experiential avoidance. Research has found that when individuals
reported using aggression in response to their own victimization,
they reported a temporary reduction in feelings of anxiety
(Visconti & Troop-Gordon, 2010) which is similar to the adult
victimization literature that found individuals who use experiential avoidance to decrease feelings of anxiety exhibit greater
aggression (Tull, Jakupcak, Paulson, & Gratz, 2007). Further
research aimed at investigating the functional relationship
between relational victimization and aggression, and taking into
account the potential uidity of these identities is needed to guide
program development.
There were several limitations to the present study. First, we
choose to implement the program through universal delivery
based on previous research suggesting that most adolescents are
affected by relational aggression. However, this classroom-based
approach makes it more difcult to address and adapt the program
to individual participant needs and may have hindered personal
disclosure. Also, because we offered the program to entire classrooms, we were unable to use random assignment and our waitlist
group reported more physical aggression at baseline. Although we
attempted to control for this by using multiple regressions
(Murray, 1998), we cannot rule out the potential impact cohort
factors could have had on our results. Another concern is the
potential diffusion of the intervention to those in the waitlisted
condition. Seventh grade students at this school are completely
integrated and having researchers in the school was a novel
situation so it is natural to assume there was discussion among
the students about the program, which could have inuenced the
ndings. Finally, in the current study we relied solely on selfreport. Although students may be poor reporters of their actions
when it comes to peer aggression (see Stassen Berger, 2007 for a
review), several studies have found that self-report is more
accurate than peer nomination measures in this age group,
(Peets & Kikas, 2006; Solberg & Olweus, 2003). Additionally, the
problem-solving subscale of the RSQ had somewhat low alphas for
this study, which could be attributed to the sample having a
narrow range or the fact that it was a small scale from a larger
measure reducing the alpha. Regardless, the alphas could limit the
amount of interpretation that can be drawn from this scale of the
measure.

5. Conclusions
Despite these limitations, our results provide preliminary
support for the notion that experiential avoidance is associated
with relational aggression, victimization, and psychological functioning. Further, they suggest that interventions can address the
way individuals cope with relational aggression, which may be a
more viable target for change. Although it is impossible to
conclude from the current study, it may be that the limited impact
of the intervention is more reective of an inadequate dose than a
awed conceptualization. Modifying the program to better address
experiential avoidance, for example by allowing more between
session practice, might increase its potency. Also, including more
teacher training and supplemental parent sessions would be
important to support learning. Programs specically aimed at
reducing negative outcomes among victims of relational aggression must continue to be a focus in risk reduction research given
the signicant academic, social, and psychological consequences of
repeated victimization. It is critical that the development of
programs be informed by the extant research and knowledge on
risk factors, take into account the interrelationship between being

relationally victimized and being relationally aggressive, and be

easily adaptable into over burdened school systems.

Conict of interest
None.

Acknowledgments
The authors would like to thank the students who participated
in the program and the school staff that willingly gave up their
classrooms and time to the project. We would also like to thank
the numerous facilitators and research assistants that made this
project successful.
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Please cite this article as: Theodore-Oklota, C., et al. A pilot of an acceptance-based risk reduction program for relational aggression
for adolescents. Journal of Contextual Behavioral Science (2014), http://dx.doi.org/10.1016/j.jcbs.2014.03.001i