Dispositional coping in individuals with anxiety disorder symptomatology: Avoidance predicts distress

Abstract

Anxiety disorders entail avoidance of feared situations and anxious experiences, which is believed to maintain anxiety pathology. It remains unclear if predominant coping styles, like avoidance, are similar across anxiety disorders or if each disorder has its own coping profile. This has important implications for conceptualization of maintenance mechanisms and treatment planning for clients presenting with different anxiety problems, since ineffective and inflexible coping may perpetuate distress. This study examined (a) differences and similarities in coping styles among individuals meeting strict screening criteria for Generalized Anxiety Disorder, Panic Disorder, Social Anxiety and Comorbid anxieties, (b) whether greater avoidance is associated with having symptoms of an anxiety disorder and with greater psychological distress and/or anxiety comorbidity. Participants (N=457; 295 female, Mage=40.09) were a community sample in Cyprus who completed measures of coping (COPE-B) experiential avoidance (AAQ-II), and the Psychiatric Diagnostic Screening Questionnaire (PDSQ) to assess anxiety symptoms. Results showed that disorders were similar in coping, characterized mostly by avoidance and self-blame. Individuals with anxiety symptoms engaged in more avoidance than controls. Greater distress and comorbidity were associated with more avoidance (experiential avoidance, denial, behavioral disengagement) as expected. Findings highlight the role of avoidance as a paramount coping style and potential maintenance mechanism of anxiety pathology. Given that empirically validated treatments, like Cognitive Behavior Therapy (CBT) and Acceptance and Commitment Therapy (ACT), mostly teach new ways of coping with symptoms and distress, understanding how individuals with anxiety disorders typically cope and how this may perpetuate their pathology is important in improving case conceptualization and setting appropriate treatment goals.