Experiential Avoidance and Hyperreflexivity as Variables Associated with Depression: A Process-Based Approach

La depresión es un problema importante de salud pública que afecta a una proporción significativa de adultos jóvenes, como los estudiantes universitarios. Para su estudio se ha propuesto un enfoque basado en procesos, que busca identificar variables psicológicas transdiagnósticas que puedan ser objeto de cambio en las intervenciones psicoterapéuticas. El propósito de este trabajo fue analizar la interrelación entre un conjunto de variables de proceso (fusión cognitiva, rumia y evitación experiencial), así como examinar la relación entre cada una de estas variables y la depresión en 368 estudiantes universitarios de entre 18 y 29 años (M = 21.35, DE = 2.36, 77.7 % mujeres). Se halló que la fusión cognitiva y la rumia conformaban una variable global denominada hiperreflexividad, mientras que la evitación experiencial constituía un constructo diferente. Al analizar un modelo de ecuaciones estructurales, se encontró que solo la hiperreflexividad predecía significativamente la depresión. Se discuten estos resultados y sus posibles implicaciones para la práctica clínica. Se recomienda seguir estudiando la hiperreflexividad como una variable supraordinada de relevancia para la psicopatologia.

Depression is a major public health problem that affects a significant proportion of young adults, such as college students. A process-based approach has been proposed for its study, which seeks to identify transdiagnostic psychological variables that can be the target of change in psychotherapeutic interventions. The purpose of this paper was to analyze the interrelation between a set of process variables (cognitive fusion, rumination, and experiential avoidance), as well as to examine the relationship between each of these variables and depression in 368 college students aged 18-29 years (M = 21.35, SD = 2.36, 77.7% female). Cognitive fusion and rumination were found to comprise an overarching variable termed hyperreflexivity, while experiential avoidance constituted a different construct. By analyzing a structural equation model, it was found that only hyperreflexivity predicted depression significantly. These findings and their possible implications for clinical practice are discussed. Further study of hyperreflexivity as a superordinate variable of relevance to psychopathology is recommended.

Childhood trauma and non-suicidal self-injury in college students: chain mediating effects of rejection sensitivity and experiential avoidance / 中华行为医学与脑科学杂志

Objective:To explore the effect of childhood trauma on non-suicidal self-injury and the chain mediating effect of rejection sensitivity and experiential avoidance.Methods:From June 2021 to April 2022, totally 1 130 college students were investigated with childhood trauma questionnaire-short form(CTQ-SF), the tendency to expect rejection scale, acceptance and action questionnaire-2nd edition(AAQ-Ⅱ) and Ottwa self-injury inventory(OSI). SPSS 25.0 and Mplus 8.0 software were used for descriptive analysis, Spearman correlation analysis, structural equation model construction and Bootstrap mediation effect test.Results:Correlation analysis showed that childhood trauma (34.64±8.25), rejection sensitivity (58.02±9.54), experiential avoidance (23.90±7.96) and non-suicidal self-injury (0(0, 1)) were all significantly positively correlated with each other( r=0.163-0.532, all P<0.01). Structural equation model showed that empirical avoidance played a partial mediating effect between childhood trauma and non-suicidal self-injury in college students, with an effect size of 0.045(95% CI=0.013-0.084). Rejection sensitivity and experiential avoidance played a chain mediating effect between childhood trauma and non-suicidal self-injury in college students, with an effect size of 0.017(95% CI=0.005-0.035). Conclusion:Childhood trauma can directly predict non-suicidal self-injury in college students, and it can also indirectly predict non-suicidal self-injury through the partial mediation effect of experiential avoidance and the chain mediation effect of rejection sensitivity and experiential avoidance.

Mediating role of psychological resilience between family intimacy and adaptability and experiential avoidance among undergraduate nursing students / 中国职业医学

Objective: To investigate the mediating role of psychological resilience in the relationship between family intimacy and adaptability and experiential avoidance among undergraduate nursing students (hereafter referred as nursing undergraduates). Methods: A total of 725 nursing undergraduates from six colleges in Guangdong Province were selected as the research subjects using convenience sampling method. The Acceptance Action Questionnaire-2nd Edition, Conner-Davidson Resilience Scale and Family Intimacy and Adaptability Scale were used to evaluate the experiential avoidance, psychological resilience, and family intimacy and adaptability, respectively. Results: The mean scores of experiential avoidance, psychological resilience and family intimacy and adaptability among nursing undergraduates were (23.4±7.7), (58.8±8.9) and (99.7±20.3), respectively. The results of the mediation analysis indicated that the total effect of family intimacy and adaptability on experiential avoidance was -0.16 (P<0.01), with a direct effect of -0.05 (P>0.05). Psychological resilience played a significant mediating role in the relationship between family intimacy and adaptability and experiential avoidance among nursing undergraduates (P<0.01). The standardized mediation effect was -0.11, accounting for 68.8% of the total effect. Conclusion: Resilience plays a mediating role between family intimacy and adaptability and experiential avoidance among nursing undergraduates.

Relación entre el uso problemático de Facebook y la evitación experiencial en jóvenes colombianos / Relationship between the Problematic Use of Facebook and Experiential Avoidance in Young Colombians

Resumen Las tecnologias facilitan la comunicación y la interacción e influyen en los comportamientos y actitudes. Sin embargo, pueden causar impacto negativo cuando interneren en las actividades cotidianas y afectan la salud mental, física y social. El objetivo del estudio fue analizar la relación entre el uso problemático de Facebook, la evitación experiencial y los componentes de la teoría biopsicosocial. Estudio de tipo correlacional con diseno transversal no experimental. En total participaron 677 jóvenes colombianos, que diligenciaron de manera voluntaria los cuestionarios de datos sociodemográficos, la escala de Aceptación y Acción-II (AAQ-II) y la escala de Adicción a Facebook de Bergen (BFAS). Los resultados muestran que los hombres presentaron mayor uso problemático de la red social y puntuaron más alto en los componentes de abstinencia y conflicto. Se encontró una relación positiva significativa entre el uso problemático, la evitación experiencial y todos los componentes de la teoría biopsicosocial. En conclusión, la evitación experiencial aporta a la comprensión del uso problemático de Facebook desde el análisis funcional y la teoría Biopsicosocial que orienta en la identificación de la sintomatología adictiva; estos hallazgos permiten direccionar futuras intervenciones.

Abstract Technologies facilitate communication and interaction, and influence behavior and attitudes. However, they can have a negative impact when they interfere with everyday activities that affect mental, physical, and social health. The objective of the study was to analyze the relationship between the problematic use Facebook, experiential avoidance, and components of the biopsychosocial theory. This study was of a correlational type with a non-experimental cross-sectional design. A total of 677 young Colombians participated, who voluntarily filled out the socio-demographic data questionnaires, the Acceptance and Action-II scale (AAQ-II), and the Bergen Facebook Addiction Scale (BFAS). The results show that men present more problematic use of the social network and scored higher on the abstinence and conflict components. A significant positive relationship was found between the problematic use, experiential avoidance, and all components of the biopsychosocial theory. In conclusion, the experiential avoidance contributes to the understanding of the problematic use Facebook from the functional analysis, and the biopsychosocial theory guides in the identification of the addictive symptomatology. These findings allow directing future interventions.

Evitación experiencial en el contexto de la contingencia sanitaria por covid-19 / Experiential avoidance in the context of the health contingency by covid-19

Resumen La actual contingencia sanitaria producto del COVID-19 esta impactado significativamente la vida de las personas en todo el mundo, teniendo repercusiones no solo a nivel físico sino también a nivel psicológico. Diversas organizaciones e investigadores a nivel nacional e internacional han llamado la atención sobre las consecuencias a nivel de salud mental que podrían evidenciarse en el corto, mediano y largo plazo. En este contexto, puede evidenciarse la presencia y cronificación de patrones de evitación experiencial a nivel general, en la medida que las personas invierten tiempo y energía en controlar, disminuir, o cambiar sus pensamientos, emociones y sensaciones desagradables frente a la pandemia, el coronavirus-2019 y/o todos los significados que surgen en cada persona. La evitación experiencial o rigidez psicológica puede prolongar el sufrimiento y tener un gran costo psicológico, por lo que la alternativa a este patrón comportamental podría encontrarse en la flexibilidad psicológica.

Abstract The current health contingency resulting from COVID-19 is having a significant impact on the lives of people around the world, having repercussions not only on a physical level but also on a psychological level. Various organizations and researchers at national and international level have drawn attention to the consequences at the mental health level that could be evident in the short, medium and long term. In this context, the presence and chronification of patterns of experiential avoidance can be evidenced at a general level, to the extent that people invest time and energy in controlling, reducing, or changing their unpleasant thoughts, emotions and sensations in the face of the pandemic, the coronavirus-2019 and/or all the meanings that arise in each person. Experiential avoidance or psychological rigidity can prolong suffering and have a great psychological cost, so the alternative to this behavioral pattern could be found in psychological fexibility.

El malestar emocional como síntoma de estrés postraumático / Emotional distress as a symptom of post-traumatic stress

El trastorno por estrés postraumático (TEPT) tiene una importante prevalencia en la población, por lo que conocer los mecanismos psicológicos para la vulnerabilidad y el mantenimiento del trastorno es claramente relevante. Entre dichos mecanismos, se ha postulado el constructo de malestar emocional como transdiagnóstico a diversos trastornos mentales. El objetivo del presente estudio fue poner a prueba un modelo hipotético que analizaba la asociación entre tres variables pertenecientes a dicho constructo (evitación experiencial, tolerancia al malestar e intolerancia a la incertidumbre inhibitoria) y el TEPT. Participaron 328 estudiantes universitarios (74.7% mujeres y 25.3% hombres, con una media de edad de 21 años) que habían experimentado al menos un acontecimiento traumático de acuerdo con los criterios del DSM-5, quienes completaron una batería de cuestionarios. Se efectuó un análisis de ecuaciones estructurales cuyos resultados apoyaron parcialmente el modelo hipotético. La evitación experiencial mostró asociarse positiva y significativamente con la tolerancia al malestar, la intolerancia a la incertidumbre inhibitoria y los síntomas del TEPT. La tolerancia al malestar también se vinculó de forma positiva y significativa con dichos síntomas. Sin embargo, la intolerancia a la incertidumbre inhibitoria no mostró relación con esta sintomatología. En apoyo a la evidencia empírica precedente, los hallazgos de este estudio inciden en el papel de la evitación experiencial y la tolerancia al malestar como variables moderadoras de la sintomatología postraumática. Asimismo, apuntan hacia la necesidad de considerar estas variables en las intervenciones psicológicas para el tratamiento del TEPT

Post-traumatic stress disorder or PTSD has an important prevalence in the population, so knowing the psychological mechanisms of vulnerability and maintenance of this disorder is clearly relevant. Among those mechanisms, the emotional distress construct has been postulated as a trans-diagnostic tool related to different mental disorders. The objective of the present study was to test a hypothetical model for the analysis of the association between three variables of this construct (experiential avoidance, distress tolerance, and inhibitory uncertainty intolerance) and PTSD. The subjects of study amounted to 328 university students (74.7% women and 25.3% men, with a median age of 21) who had experienced at least one traumatic event according to the DSM-5 criteria. They were made to complete a set of questionnaires. A structural equation analysis was carried out, with results partially coincident with the hypothetical model. Exponential avoidance showed a positive and significant association with distress tolerance, inhibitory uncertainty intolerance and PTSD symptoms. Distress tolerance was also associated with these symptoms in a positive and significant way. However, inhibitory uncertainty intolerance was not associated with this symptomatology. Following the preexisting empirical evidence, the findings of this study have an impact on the role of experiential avoidance and distress tolerance, as variables that moderate post-traumatic symptomatology. Furthermore, the findings point to the need to consider these variables in psychological interventions for the treatment of PTSD

Intermediary role of experiential avoidance in neurosis and posttraumatic stress response in firefighters / 中国职业医学

OBJECTIVE: To explore the mediating effect of experiential avoidance on neurosis and posttraumatic stress response in firefighters. METHODS: A cluster random sampling method was used to select 275 male firefighters from 26 Fire Alarm squadrons in a province of China.The Neuroticism subscale of Eysenck Personality Questionnaire Short Scale, the Acceptance and Action Questionnaire-Second Edition, and the Impact of Event Scale were used to investigate the relationship of neurosis, experiential avoidance and posttraumatic stress response. RESULTS: The median score of neurosis, experiential avoidance and posttraumatic stress response was 5, 21 and 15, respectively. Both neurosis and experiential avoidance were positively correlated with posttraumatic stress syndromes(Spearman correlation coefficient were 0.45 and 0.45, P<0.01). The total effect of neurosis on posttraumatic stress response in firefighters was 0.57. The intermediary role of experiential avoidance on neurosis and posttraumatic stress response was 0.19, accounting for 33.33% of the total effect. CONCLUSION: Experiential avoidance plays a partial positive mediating role between neurosis and posttraumatic stress response in firefighters.

The mediating role of experiential avoidance and thought suppression between trait mindfulness and rumination in undergraduates / 中华行为医学与脑科学杂志

Objective To investigate the relationship between trait mindfulness( TM) and rumina-tion,as well as the mediating effects of experiential avoidance(EA) and thought suppression(TS) in under-graduates. Methods A sample of 1 219 undergraduates was recruited to complete Mindful Attention Aware-ness Scale,Acceptance and Action Questionnaire-Ⅱ,the White Bear Suppression Inventory and Rumination Response Style Questionnaire. Results (1) The significant positive correlations of each two different fac-tors were found among experiential avoidance (18. 020±7. 446),thought suppression (47. 769±10. 011) and rumination (47. 668±10. 497),and the correlation coefficients were 0. 466,0. 546 and 0. 525 respectively, all P<0. 01. TM (64. 977± 9. 623) was found to be significantly related with EA ( r=-0. 450),TS ( r=-0. 424) and rumination (r=-0. 527),all P<0. 01. (2) Partially mediating effect of EA ( effect value=-0. 132) and TS (effect value=-0. 073) were both found in TM and rumination,and the proportion of these two effects were 25. 0% and 13. 9%,respectively. The chain mediating effect of EA and TS (effect value=-0. 042 ) was also found between TM and rumination, whose indirect effect size was 8. 0%. Conclusion The relationship between TM and rumination in undergraduates can be mediated by EA and TS respectively,as well as their chain effect.

Application of acceptance and commitment therapy in eating disorders / 中华行为医学与脑科学杂志

Acceptance and Commitment Therapy (ACT) aims at correctly recognizing the different sides of life, accepting its inevitable pain, defining its true value and committing to action.Its ultimately aim is to improve psychological flexibility and lead a more fulfilling and meaningful life.Patients with Eating Disorders (ED) often have personality characteristics such as experiential avoidance, rigid behavior, and lack of motivation.Therefore, Acceptance and Commitment Therapy is particularly suitable for patients with Eating Disorders.This article make a brief overview of the ACT firstly, then introduces the definition, epidemiology and etiology of ED.By reviewing the relevant literatures on the use of ACT in the treatment of ED in recent years, we point out the advantages of using ACT and the possible mechanism of ACT in the treatment of ED, the future research directions and issues needing attention.

Study of relationship among sense of meaning of life, experiential avoidance and self consistency in patients under hemodialysis based on theory of logotherapie / 中国实用护理杂志

Objective Analysis the relationship between influencing factors and self consistency among patients under maintenance hemodialysis. Methods A total of 146 patients under maintenance hemodialysis were investigated , Research tools include: the self-designed basic information questionnaire, Self Consistency and Congruence Scale, The Meaning in Life Questionnaire,and Acceptance Action Questionnaire. One-way anova, correlation analysis,multiple regression analysis were used to analyze the relationship between influencing factors and self consistency. Results The average score of self consistency and congruence was (94.34±16.13). The score of self-stereotype dimension was (21.22±5.16), higher than that of norm of college students (t=5.132,P<0.01).While there was no difference in the other 2 dimensions of self consistency. The predictors of self consistency and congruence included Duration of dialysis, education level, sense of meaning of life, and experiential avoidance of patients,and these explained 55.40% of the total variance. Conclusions Promoting sense of meaning of life and lower experiential avoidance may help to improve self consistency and congruence for patients under maintenance hemodialysis.

Incorporación del mindfulness en el aula: un estudio piloto con estudiantes universitarios / Mindfulness Classroom Implementation: A Pilot Study with University Students

Resumen El objetivo del estudio fue analizar los efectos de un programa breve de mindfulness adaptado al contexto del aula, en relación con el nivel de mindfulness (MAAS), evitación experiencial (AAQ-II), ansiedad (STAI) y satisfacción vital (SWLS). La muestra estuvo conformada por 115 estudiantes universitarios. Tras la participación en el programa, los estudiantes aumentaron significativamente los niveles de satisfacción vital y ansiedad estado, no se encontraron diferencias en el resto de variables. Sin embargo, el aumento de la satisfacción vital se relacionó con el aumento del nivel de mindfulness al final del programa (coincidiendo con el inicio de los exámenes). En conclusión, un programa breve de mindfulness mejora la satisfacción vital, aun en un período de alto nivel de ansiedad como es el periodo de exámenes.

Abstract The aim of this pilot study was to analyze the effects of a brief mindfulness program adapted to the academic context, to acknowledge the influence on the level of mindfulness (MAAS), experiential avoidance (AAQ-II), anxiety (STAI) and life satisfaction (SWLS). The sample consisted of 115 college students. After participating in the programme, students showed significantly higher levels of life satisfaction and state anxiety and no differences were found in mindfulness, experiential avoidance and trait anxiety. However, the increase in life satisfaction was related to the increased level of mindfulness at the end of the program (which concurred with the beginning of the exams). In conclusion, a brief mindfulness program improved life satisfaction even in a period of high anxiety, such as the exams period.

Evitación experiencial, afrontamiento y ansiedad en estudiantes de una universidad pública de Lima Metropolitana / Experiential avoidance, coping, and anxiety in students from a public university in Lima

La evitación experiencial (EE) ­o (in)flexibilidad psicológica­ es un concepto central en las terapias contextuales y ha sido propuesta como una dimensión transdiagnóstica de la psicopatología. En el presente estudio, se buscó probar si la EE y otras estrategias de afrontamiento predicen independientemente la ansiedad-estado y la ansiedad-rasgo. Se aplicó un conjunto de medidas (el AAQ-II, una versión modificada del COPE breve, y el IDARE) a 284 estudiantes de pregrado de una universidad pública de Lima. De acuerdo con los resultados, la ansiedad (estado y rasgo) mostró correlaciones significativas con la EE, la baja actitud de solución de problemas, la autoculpa y el uso de sustancias. Sin embargo, al someter estas variables a análisis de regresión múltiple, solo la EE, la baja actitud de solución de problemas y la autoculpa resultaron predictores significativos de la ansiedad-rasgo; de estos, solo la EE contribuyó de manera importante al modelo (ΔR² = .16). Por otra parte, ninguna de las variables estudiadas predijo de manera significativa la ansiedad-estado. Se concluye que el intento de evitar los pensamientos y emociones desagradables constituye un elemento fundamental de la ansiedad-rasgo. Se discute este hallazgo en relación con estudios previos y se brindan sugerencias para nuevas investigaciones

Experiential avoidance (EA)­or psychological (in)flexibility­is a central concept in contextual therapies, and it has been proposed as a transdiagnostic dimension of psychopathology. We intended to test whether EA and other coping strategies independently predict both state and trait-anxiety. We administered a set of measures (the AAQ-II, a modified version of the Brief COPE, and the STAI) to 284 undergraduates from a public university in Lima, Peru. Results showed that EA, lack of problem solving, self-blame, and substance use were all significantly related to state and trait-anxiety. However, after submitting these variables to multiple regression analyses, only EA, lack of problem solving, and self-blame remained significant predictors of trait-anxiety; of these, only EA made a significant improvement to the model (ΔR² = .16). On the other hand, none of the variables under study were significant predictors of state-anxiety. We concluded that the effort to avoid unpleasant thoughts and emotions constitutes a central aspect of trait-anxiety. We discussed these findings in light of previous studies, and gave suggestions for future research.

Research on experiential avoidance, cognitive fusion and type D personality of pregnant / 中华行为医学与脑科学杂志

Objective To explore the relationship among experiential avoidance,cognitive fusion and type D personality in pregnant women.Methods 309 pregnant women were assessed with self-made general information questionnaire,acceptance and action questionnaire-2nd edition (AAQ-Ⅱ),cognitive fusion questionnaire(CFQ) and type D personality scale(DS14).Results Average score of AAQ-Ⅱ and CFQ of 309 pregnant women were (16.41±7.55) and (24.24± 10.90),respectively.According to the type D personality questionnaire scores,the subjects were divided into four groups.Average score of each group on AAQ-Ⅱ and CFQ was respectively (21.25 ± 8.18) and (31.12± 10.99) for type D personality group (Group 1),(19.80±6.14) and (27.67±9.76) for negative emotion group(Group 2),(15.12±6.40) and (22.16±9.56)for social inhibition group (group 3) and (14.02±6.61) and (21.18±10.03) for group without negative emotions and social inhibition (group 4).The differences between groups were statistically significant (F=19.44,17.372,all P＜0.01).Correlation analysis revealed that AAQ-Ⅱ and CFQ were positively related to NA and SI (r=0.484,0.251,0.477,0.302,P＜0.05).NA and SI all entered the AAQ-Ⅱ regression equation and CFQ regression equation respectively:Y1 =4.655+ 1.032X1 + 0.836X2,Y2 =8.013+ 1.233X1 + 0.745X2 (Y1 as AAQ-Ⅱ,Y2 as CFQ,X1 as NA,X2 as SI).Conclusion Pregnant women with type D personality have the worst psychological flexibility.The two demensions of type D personality are predictive to experiential avoidance and cognitive fusion.

Impact of Childhood Trauma and Parents' Problem Drinking on Problem Drinking of their University Student Children: Mediating Effects of Experiential Avoidance / 정신간호학회지

PURPOSE: The purpose of this study was to examine the mediating effects of experiential avoidance on the impact of childhood trauma and parent problem drinking on problem drinking of the university student children of theses parents. METHODS: This study was conducted using a descriptive survey design. Participants were 250 university students from four universities in Gwangju city, Jeollanam-do, Jeollabuk-do, and Gyongsangnam-do. Data were collected from March 2 to March 31 2015 using self-report questionnaires. Data were analyzed using SPSS 19.0. RESULTS: There were significant positive correlations between childhood trauma, parent problem drinking, experiential avoidance and university students' problem drinking. It was found that experiential avoidance partially mediated the relationship between parent problem drinking and university students' problem drinking. Also, it was found that experiential avoidance fully mediated the relationship between childhood trauma and university students' problem drinking. CONCLUSION: Based on the present findings, nursing interventions should be developed to decrease experiential avoidance, with additional consideration of childhood trauma and parent problem drinking, in order to prevent problem drinking among university students.

Research on postpartum depression and experiential avoidance of parturient / 中华行为医学与脑科学杂志

Objective To explore the relationship between postpartum depression and experiential avoidance of parturient and to provide empirical evidences for acceptance and commitment therapy in mental treatment of postpartum depression.Methods 309 pregnant women were assessed with self-made general information questionnaire,self-rating depression scale (SDS) and acceptance and action questionnaire-2nd edition (AAQ-Ⅱ) in predelivery periods and 3-7 days after childbirth respectively.Results AAQ-Ⅱ scores in the predelivery or postpartum depression group ((18.54±8.25),(19.07±7.82)) were higher than that in the normal group((15.47±7.03),(14.57±6.57)),and the difference was statistically significant(t=-3.15,-5.07,all P＜0.01).It was found that the predelivery or postpartum AAQ-Ⅱ scores were positively associated with the SDS scores of predelivery periods and postpartum periods respectively(r=0.34,0.34,0.24,0.42,all P＜0.01).Hierarchical multiple regression analyses were then conducted.In the first block,neonatal exceptional conditions and the predelivery SDS significantly explained variance in postpartum depression(β=0.09,0.62,all P＜0.01).In the second block,the predelivery AAQ-Ⅱ still had a significant effect on postpartum depression (β=0.13,P=0.006,△R2=0.01,P=0.006),despite control the age of parturient women,postpartum complication,neonatal exceptional conditions and the predelivery SDS.Conclusion A function to predict the occurrence of maternal postpartum depression is obtained from the experiential avoidance which is attributed to the risk of maternal postpartum depression.