Levels Of Experiential Avoidance Research Articles

Effects of Brief Acceptance and Cognitive Reappraisal Interventions on Experiential Avoidance in Socially Anxious Individuals: A Preliminary Investigation.

The current study compared the effects of 15-min acceptance-based and cognitive reappraisal-based interventions on experiential avoidance (EA) in socially anxious college students who participated in an experimental public speaking task. Participants were randomly assigned to receive one of the two interventions designed to aid in preparation for a 5-min laboratory-based public speaking task. Results indicated that participants receiving the acceptance-based intervention reported significantly lower levels of EA at the post-public speaking task measurement time, indicating that this brief acceptance-based intervention yielded the proposed mechanism of action in the sample used for this study. These findings highlight the importance of process-based accounts of cognitive-behavioral psychotherapy and shed light on the importance of developing interventions for alleviating social anxiety.

Measuring structural model invariance across internet-recruited and hospital-recruited IBD patients: Experiential avoidance’s effect on psychopathological symptoms

Research has questioned whether it is feasible to assess psychosocial variables through web-based recruitment methods. Previous literature on IBD focused exclusively on testing differences on psychosocial scores and did not test the invariance between types of recruitment on the relationships between variables. The aim of the present study is thus to analyse structural invariance between internet-recruited and hospital-recruited groups of IBD patients on a mediation model with theoretical basis on previous studies (experiential avoidance as possible mediator of the association between IBD symptomatology and psychopathology). The internet sample included 137 IBD patients recruited through a patients association, and the hospital sample comprised 66 IBD patients. Structural equation modelling was used; a multiple-group comparison was conducted to examine model invariance between samples. Although the internet sample presented higher levels of experiential avoidance and psychopathological symptoms compared to the hospital sample, the relationships between these variables were invariant across groups. Experiential avoidance partially mediated the impact of IBD symptomatology on levels of stress, anxiety, and depression symptoms in a similar way for online respondents and hospital-recruited patients. This is a new finding that argues for the validity of web-based research methods.

A Preliminary Examination of an Acceptance and Commitment Therapy-Based Program for Incarcerated Domestic Violence Offenders.

Batterers intervention programs (BIPs) have only a marginal impact on domestic violence (DV) recidivism, in part because treatment attrition is high. The current study evaluates a new BIP based on Acceptance and Commitment Therapy (called ACTV, Achieving Change Through Values-Based Behavior) in a sample of incarcerated DV offenders who failed to complete community-based BIP (N = 23). The current study examined participants' risk factors and assessed criminal justice outcomes in the 1 year following treatment completion. The men exhibited high levels of experiential avoidance, adverse childhood experiences, psychopathy, and attachment when compared to clinical and forensic samples from past research. Consistent with the theory underlying ACTV, experiential avoidance decreased significantly over the course of treatment. In addition, 1 out of 22 (4.5%) had a domestic assault charge in the 1-year follow-up period. Overall, the current study offers preliminary support for the use of ACTV with noncompliant, incarcerated offenders.

Next-day effects of dysfunctional and functional emotion regulation and the moderating role of experiential avoidance

This work examined the influence of trait experiential avoidance (EA) on the relationship between functional versus dysfunctional emotion regulation (ER) strategies and next-day negative emotion. Participants (N = 154) reported levels of EA, and then provided daily measurements of negative emotional intensity and frequency of the use of dysfunctional and functional ER strategies that are focused inwards towards the self (internal) or outwards towards others (external) for six consecutive days. Hierarchical linear modeling indicated that higher internal-dysfunctional ER strategy use predicted higher next-day emotional intensity. Also, trait EA moderated the relationship between external-dysfunctional ER use and next-day negative emotion: lower EA individuals experienced higher, but higher EA individuals experienced lower, negative emotion the day following increased external-dysfunctional strategy use. Findings suggest internal-dysfunctional ER is associated with increased next-day negative emotion. As well, external-dysfunctional strategies are associated with next-day emotion among individuals who are more aware of emotion (i.e., lower EA), and may lead to a blunted response among those higher in EA. A range of explanations for the moderating effect of trait EA on the relationship between external-dysfunctional ER and next day emotion are discussed.

RELATIONSHIP OF MODELS OF CONSISTENCY AND PSYCHOLOGICAL FLEXIBILITY WITH PERSECUTORY DELUSIONS

The goal of research is to assess the preference for consistency, cognitive fusion and experiential avoidance levels and their of persons with delusional persecution delusions, and interrelationship of these items. In addition, it was aimed to investigate the attitudes of individuals with persecution delusions towards the inconsistency of the relationship with other cognitions and their discomfort caused by inconsistency. The patient group with delusions consisted of 82 patients was who were diagnosed with schizophrenia, schizophreniform, schizoaffective disorder, delusional disorder, unspecified psychotic For the control group, 86 people who showed similar characteristics were included in the study Participants in both groups fill form for the Sociodemographic Data Form, Preference for Consistency Scale (PFC), Peters Delusion Inventory (PDI, only items for Persecutory Delusion), Cognitive Fusion Scale (CFQ), acceptance and Action questionnaire-II (AAQ-II) themselves. In addition, the Positive and Negative Syndrome Scale (PANSS, only positive symptom subscale) was applied by the researcher in the patient group with delusions. There was a significant difference between the patient group with delusions and the control group for the scores of PFC, AAQ-II and CFQ (p

Examining experiential avoidance as a mediator of the relation between anxiety sensitivity and depressive symptoms

ABSTRACTInitial evidence suggests that experiential avoidance (EA) mediates the relation between anxiety sensitivity (AS) and depression. We examined the AS-EA-depression pathway, examining both concurrent, and prospective (cross-lag), mediation models. Utilizing data from a study that examined the effects of exercise on AS (N = 60), we modeled depressive symptoms, EA, and AS over four time points. Time-varying predictors were disaggregated into between-subjects (each person’s mean level of the predictor) and within-subjects change (each person’s deviations, at each time point, from their mean level on the predictor) components. Tests of the concurrent relations were partially consistent with predictions, with mean EA levels, but not within-subjects changes in EA, partially mediating the relation between AS and depression symptom severity. However, the prospective, cross-lag mediation model, in which AS predicted future EA controlling for previous EA, and EA predicted future depression, controlling for previous depression, yielded no significant effects. These results suggest that observed between-subjects mediation findings, found here and in previous studies, may not replicate using more stringent, quasi-causal, cross-lag mediation analyses. These results highlight the importance of estimating causal pathways in mediation analyses. Clinical implications and directions for future research are discussed.

Community sample evidence on the relations among behavioural inhibition system, anxiety sensitivity, experiential avoidance, and social anxiety in adolescents

Social anxiety in adolescence can have severe consequences including underachievement and school drop-out, psychopathology, and substance use disorders. The development of social anxiety in adolescents is a complex and poorly understood process. Temperamental predispositions such as behavioural inhibition are significant risk factors but the specific path leading from behavioural inhibition to social anxiety remains unclear. One potential pathway is that temperament leads to social anxiety through learned self-regulation strategies and cognitive predispositions, a hypothesis that has not yet been investigated in adolescents. In an attempt to investigate further this idea, we ran parallel multiple mediation analysis to examine whether greater behavioural inhibition system sensitivity is linked to higher social anxiety via greater anxiety sensitivity and experiential avoidance levels in a random community sample of high-school adolescents (N= 718). The results confirmed our hypotheses. Independently of gender and after controlling for anxiety psychopathology and depression levels, greater behavioural inhibition system sensitivity was associated with more severe social anxiety in adolescents both directly and indirectly through greater experiential avoidance and more severe anxiety sensitivity. Given the fact that social anxiety is a serious cause of academic and social impairment in adolescence, the present findings suggest malleable risk factors that can be effectively addressed in targeted prevention and treatment interventions. Results are discussed in light of previous relevant findings and in relation to relevant theoretical and methodological issues and clinical implications.

The impact of experiential avoidance on the relations between illness representations, pain catastrophising and pain interference in chronic pain

Objective: The aim of this study was to examine the effects of experiential avoidance (EA) on the indirect relationship of chronic pain patients’ illness representations to pain interference, through pain catastrophisingDesign and main outcome measure: The sample consisted of 162 patients diagnosed with an arthritis-related or a musculoskeletal disorder. The effects of EA on the pathway between illness representations, pain catastrophising and pain interference were examined with PROCESS, a computational tool for SPSSResults: After controlling for patient and illness-related variables and pain severity, the ‘illness representations–pain catastrophising–pain interference’ pathway was interrupted at the higher levels of EA. The reason was that, at the high levels of EA, either the relation of illness representations to pain catastrophising or the relation of pain catastrophising to pain interference was not statistically significant.Conclusion: The findings indicate that EA is not a generalised negative response to highly aversive conditions, at least as far as the factors examined in this study are concerned. EA may rather reflect a coping reaction, the impact of which depends on its specific interactions with the other aspects of the self-regulation mechanism. At least in chronic pain, EA should become the focus of potential intervention only when its interaction with the illness-related self-regulation mechanism results in negative outcomes.

The longitudinal effects of experiential avoidance on depression symptoms in patients with inflammatory bowel disease

Inflammatory bowel disease (IBD) has been vastly associated with the development of depression and it is thus considered that the mechanisms that underlie this link should be explored. The present study aimed to examine the longitudinal effects of IBD symptoms and a maladaptive emotion regulation process, experiential avoidance (defined as the tendency to attempt to control internal experiences), on depression symptoms. The sample comprised 116 IBD patients of both sexes that completed validated self-report measures on an online platform in three different times (equally spaced 9 months apart) during an 18-month period. Results demonstrated that IBD symptomatology at baseline was linked to experiential avoidance and depressed mood 9 and 18 months later. The level of experiential avoidance at baseline was also correlated with the subsequent experience of depression symptoms, 9 and 18 months later. Results also revealed that, although IBD symptomatology at baseline predicted depressive symptomatology 18 months later (β = 0.24; P = 0.008), when experiential avoidance at baseline was added to this model, this process became the only predictor of the outcome (β = 0.60; P < 0.001; R2 = 0.41). These results corroborate previous literature by indicating that IBD symptomatology may lead to depression symptomatology. Nevertheless, the current study additionally revealed that the engagement in experiential avoidance – that is, in attempts at controlling the frequency, form or intensity of internal experiences – might have a greater role on the determination of patients’ depressed mood than the experience of adverse physical symptomatology. Maladaptive forms of emotion regulation in IBD patients should be targeted to prevent depression symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

An Open Effectiveness Trial of a Multimodal Inpatient Treatment for Depression and Anxiety Among Adults With Serious Mental Illness

Objective: This prospective open effectiveness trial examined symptom change trajectories and rates of remission from depression and anxiety in an intensive multimodal inpatient treatment for adults with serious mental illness (SMI). Patient baseline characteristics were examined as mediators/moderators of treatment response. Methods: Adult inpatients with SMI (N = 994) completed an average of 39 days of inpatient treatment. Latent growth curve (LGC) methods were used to model symptom trajectories, estimating expected remission based on individual patterns of change observed across the sample. Results: Absolute reductions in symptoms were substantial, with large effect size improvements for both depression (d = 1.21, 95% CI [1.13, 1.29]) and anxiety (d = 1.13, 95% CI [1.05, 1.21]). For those presenting with elevated depressive symptoms (Patient Health Questionnaire-Depression ≥ 5.0; 87.5% of the sample), 46.9% evidenced remission from admission to discharge. Among patients presenting with significant anxiety (Patient Health Questionnaire–Generalized Anxiety Disorder Screener ≥ 5.0; 84.5% of the sample), 50.0% evidenced remission from admission to discharge. Mediation analyses revealed that depression and anxiety severity decreased more rapidly with increasing age and initial levels of experiential avoidance. Conclusions: Rates of remission of depression and anxiety were greater than anticipated in this large cohort of adult SMI inpatients and may be related to intensity and length of hospitalization.

The role of experiential avoidance in the relation between anxiety disorder diagnoses and future physical health symptoms in a community sample of young adult women

Individuals diagnosed with an anxiety disorder report more physical health problems than those without an anxiety disorder. Few studies have examined the relation of anxiety disorders to later physical health symptoms, or the processes that may explain this relation. One process of interest is experiential avoidance (EA), which is commonly reported in populations characterized by high anxiety and often leads to health-compromising behaviors. The present study examined the relations between anxiety disorder diagnostic status, EA, and physical health symptoms in a community sample of young adult women. Results revealed a significant association between an anxiety disorder diagnosis and physical health problems four months later. Furthermore, levels of EA accounted for this relation. Findings highlight the potential utility of targeting EA as a method for improving health outcomes among individuals with anxiety disorders.

Stressors and anxiety in dementia caregiving: multiple mediation analysis of rumination, experiential avoidance, and leisure.

Despite the robust associations between stressors and anxiety in dementia caregiving, there is a lack of research examining which factors contribute to explain this relationship. This study was designed to test a multiple mediation model of behavioral and psychological symptoms of dementia (BPSD) and anxiety that proposes higher levels of rumination and experiential avoidance and lower levels of leisure satisfaction as potential mediating variables. The sample consisted of 256 family caregivers. In order to test a simultaneously parallel multiple mediation model of the BPSD to anxiety pathway, a PROCESS method was used and bias-corrected and accelerated bootstrapping method was used to test confidence intervals. Higher levels of stressors significantly predicted anxiety. Greater stressors significantly predicted higher levels of rumination and experiential avoidance, and lower levels of leisure satisfaction. These three coping variables significantly predicted anxiety. Finally, rumination, experiential avoidance, and leisure satisfaction significantly mediated the link between stressors and anxiety. The explained variance for the final model was 47.09%. Significant contrasts were found between rumination and leisure satisfaction, with rumination being a significantly higher mediator. The results suggest that caregivers' experiential avoidance, rumination, and leisure satisfaction may function as mechanisms through which BPSD influence on caregivers' anxiety. Training caregivers in reducing their levels of experiential avoidance and rumination by techniques that foster their ability of acceptance of their negative internal experiences, and increase their level of leisure satisfaction, may be helpful to reduce their anxiety symptoms developed by stressors.

Acculturative stress and experiential avoidance: relations to depression, suicide, and anxiety symptoms among minority college students

Although college campuses represent strategic locations to address mental health disparity among minorities in the US, there has been strikingly little empirical work on risk processes for anxiety/depression among this population. The present investigation examined the interactive effects of acculturative stress and experiential avoidance in relation to anxiety and depressive symptoms among minority college students (n = 1,095; 78.1% female; Mage = 21.92, SD = 4.23; 15.1% African-American (non-Hispanic), 45.3% Hispanic, 32.5% Asian, and 7.1% other races/ethnicities. Results provided empirical evidence of an interaction between acculturative stress and experiential avoidance for suicidal, social anxiety, and anxious arousal symptoms among the studied sample. Inspection of the significant interactions revealed that acculturative stress was related to greater levels of suicidal symptoms, social anxiety, and anxious arousal among minority college students with higher, but not lower, levels of experiential avoidance. However, in contrast to prediction, there was no significant interaction for depressive symptoms. Together, these data provide novel empirical evidence for the clinically-relevant interplay between acculturative stress and experiential avoidance in regard to a relatively wide array of negative emotional states among minority college students.

Effect of an acceptance and commitment group therapy in the treatment of panic disorder and agoraphobia. A preliminary study

IntroductionAcceptance and commitment therapy for the treatment of panic disorder and agoraphobia has been a big boost in last years, and there are preliminary studies about its efficacy. However, most studies have used individual interventions.ObjectivesEvaluate the effect of an acceptance and commitment group therapy in patients with panic disorder and agoraphobia.MethodsThe sample consisted of 24 patients, aged between 18 and 55 years old, who were referred to groups by psychologists and psychiatrists of Mental Health Center. The intervention in each group consisted of 12 treatment sessions of 1 h 30 m duration, weekly. One pretest and posttest evaluation was conducted. The variables studied were: severity of panic disorder (Panic Disorder Severity Scale [PDSS]), fear of physical sensations (Body Sensations Questionnaire [BSQ]), frequency of catastrophic thoughts (Agoraphobic Cognitions Questionnaire [ACQ]) and level of experiential avoidance (Acceptance and Action Questionnaire-II [AAQ-II]).ResultsThe mean scores for all variables studied decreased in the post-evaluation. Means in post-evaluation were significantly lower (t Student, a = 0.10) in three of the four variables studied: severity of the condition (P = 0.001), frequency of catastrophic thoughts (P = 0.038) and level experiential avoidance (P = 0.073). In other words, patients had fewer panic attacks after treatment, and those who had were less intense, they had less catastrophic thoughts about consequences of anxiety, and they were better to accept their feelings and thoughts.ConclusionsAlthough it is necessary to continue the study with a larger sample, these preliminary results support the use of ACT in group format in the treatment of panic disorder and agoraphobia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Long Term Role of Anxiety Sensitivity and Experiential Avoidance on Pain Intensity, Mood, and Disability among Individuals in a Specialist Pain Clinic.

Background. Anxiety sensitivity (AS) and experiential avoidance (EA) have been shown to have an interactive effect on the response an individual has to chronic pain (CP) potentially resulting in long term negative outcomes. Objective. The current study attempted to (1) identify distinct CP subgroups based on their level of EA and AS and (2) compare the subgroups in terms of mood and disability. Methods. Individuals with CP were recruited from an academic pain clinic. Individuals were assessed for demographic, psychosocial, and personality measures at baseline and 1-year follow-up. A cluster analysis was conducted to identify distinct subgroups of patients based on their level of EA and AS. Differences in clinical outcomes were compared using the Repeated Measures MANOVA. Results. From a total of 229 participants, five clusters were formed. Subgroups with lower levels of AS but similar high levels of EA did not differ in outcomes. Mood impairment was significantly greater among those with high levels of EA compared to lower levels (p < 0.05). Significant improvement in disability (p < 0.05) was only seen among those with lower levels of EA and AS. Conclusions. This cluster analysis demonstrated that EA had a greater influence on mood impairment, while both EA and AS levels affected disability outcomes among individuals with CP.

Anxiety Sensitivity, Experiential Avoidance, and Mindfulness Among Younger and Older Adults: Age Differences in Risk Factors for Anxiety Symptoms.

In this cross-sectional study, we examined age-related differences in anxiety sensitivity (AS), experiential avoidance (EA), and mindfulness among younger adult students (N=426; M age=20.1 years) and community-dwelling older adults (N=85; M age=71.8 years). Participants anonymously completed the Anxiety Sensitivity Index-3, Acceptance and Action Questionnaire-II, Mindful Attention Awareness Scale, Kentucky Inventory of Mindfulness Skills, Beck Anxiety Inventory, Geriatric Anxiety Scale, and State-Trait Anxiety Inventory. Independent t tests indicated that younger adults reported significantly higher levels of AS and EA, whereas older adults reported significantly higher levels of trait mindfulness. Correlational analyses demonstrated that AS and EA were significantly associated with each other and with anxiety-related symptoms. However, trait mindfulness was significantly inversely related to AS, EA, and to trait and state anxiety. To date, these three factors have yet to be examined simultaneously within the context of age differences, and the present study illuminates these differences as well as their relationships. AS, EA, and low mindfulness appear to be significant correlates for anxiety-related symptoms in younger and older adults.

La evitación experiencial como dimensión funcional de los trastornos de depresión, ansiedad y psicóticos

Lately the experiential avoidance (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996) has been proposed as an element shared by different psychiatric syndromes. Several studies have been conducted outside of Mexico with the aim to identify whether there is any relationship between experiential avoidance (EA) and other psychiatric disorders. Following this argument, the present study was conducted to identify differences in the levels of experiential avoidance among people who have a psychiatric diagnosis (anxiety, depression and psychotic disorder) and non-clinical population from the city of Mérida Yucatán. The Acceptance and Action Questionnaire II adapted for Yucatán population (Patrón, 2010) was applied to 108 participants. The sample was divided into four groups of 27 members depending on the diagnosis: (1) anxiety, (2) depression, (3) psychotic and (4) non-clinical. Statistical analysis was performed using simple variance test. The results suggest that there were significant differences between clinical and nonclinical groups and between the group with a diagnosis of psychotic disorder and groups with depression and anxiety disorder. These findings lead to study in more depth the role that the EA plays in the different types of schizophrenia, and to suggest possible techniques designed to influence the EA as part of the treatment of various disorders.

A randomized controlled trial of acceptance and commitment therapy for aggressive behavior.

The objective of the current research was to test the efficacy of a group-based Acceptance and Commitment Therapy (ACT) intervention for partner aggression, compared with a support and discussion control group, in a clinical sample of adults. One hundred one participants (mean age = 31; 68% female; 18% minority) who endorsed recently engaging in at least 2 acts of partner aggression were randomly assigned to receive ACT or a support-and-discussion control condition. Both interventions consisted of 12 weekly 2-hr sessions. Assessments at pretreatment, during treatment, posttreatment, and 3 and 6 months after treatment measured psychological aggression (Multidimensional Measure Emotional Abuse Scale [MMEA]), physical aggression (Conflict Tactics Scales [CTS-2]), experiential avoidance (Avoidance and Action Questionnaire [AAQ]), and emotion dysregulation (Difficulties in Emotion Regulation Scale [DERS]). RESULTS of growth curve modeling analyses demonstrated that participants in the ACT group had significantly greater declines in psychological and physical aggression from pre- to posttreatment and from pretreatment to follow-up and that 6-month treatment outcomes were partially mediated by levels of experiential avoidance and emotion dysregulation at posttreatment. The results of this first trial of ACT for aggressive behavior indicate that the ACT group significantly reduced both physical and psychological aggression and that these changes were significantly greater than those of the control group, suggesting that an ACT approach to aggression may serve as an efficacious treatment for aggression.

Short-term pain for long-term gain: The role of experiential avoidance in the relation between anxiety sensitivity and emotional distress

Research has provided evidence of an interactive effect between anxiety sensitivity (AS) and experiential avoidance (EA) in predicting both anxiety and posttraumatic stress (PTS) symptomatology. Additionally, theory suggests that EA alleviates distress in the short-term, but exacerbates it in the long-term. The present cross-sectional study was developed to replicate the noted findings and examine the interaction (EA×AS) in the context of an emotionally evocative task. It was predicted that, among high AS participants, high EA would (a) reduce the likelihood of experiencing short-term increases in negative affect following the task, and (b) increase the likelihood of anxiety and PTS symptomatology. Undergraduate participants (N=199) completed a battery of self-report questionnaires and an emotionally evocative task. As predicted, positive associations were observed between AS and both anxiety and PTS symptoms, but only among high EA participants. Additionally, AS only predicted increases in negative affect following the emotionally evocative task for those with lower levels of EA, thus providing empirical evidence of the affect regulatory function of EA among those who fear anxiety-related bodily sensations. These findings help to elucidate the motives for the use of avoidance among those high in AS. Conceptual and clinical implications are discussed.

A Case Study: An ACT Stress Management Group in a University Counseling Center

The aim of this study was to examine the effectiveness of an acceptance and commitment therapy (ACT) stress management group in a college counseling center setting. This study explored (a) the effectiveness of ACT in increasing participants’ ability to tolerate distress, which directly affects their ability to function in a stressful college setting; (b) the effectiveness of ACT in decreasing participants’ level of experiential avoidance, which directly affects their willingness to engage in their day-to-day tasks, responsibilities, and social interactions; and (c) the impact of ACT treatment on anxiety symptoms traditionally targeted in cognitive-behavioral therapy interventions. The results of this initial investigation show promising support for the prediction that an ACT Stress Management Group would significantly reduce participants’ level of experiential avoidance and increase their ability to tolerate distress.