title: A longitudinal study of experiential avoidance in emotional disorders.
abstract: The aim of this study was to examine the degree in which measurements of trait experiential avoidance (EA) are affected by current emotional disorder and whether EA is a causal factor in the course of emotional disorders (anxiety and depressive disorders) and the development of comorbidity among emotional disorders. In a sample of 2,316 adults aged 18 to 65, consisting of healthy controls, persons with a prior history of emotional disorders, and persons with a current emotional disorder, DSM-IV-based emotional disorders (CIDI: Composite Interview Diagnostic Instrument) were assessed at T2 and 2 (T4) and 4years later (T6) and experiential avoidance (AAQ: Acceptance and Action Questionnaire) at T2 and T4. Results showed that EA scores were stable over a 2-year period notwithstanding state fluctuations because of current emotional disorder. Moreover, EA scores at T2 predicted changes in distress (major depressive disorder, dysthymia, generalized anxiety disorder) and in fear disorders (social anxiety disorder, panic disorder with or without agoraphobia, agoraphobia without panic) at T4. Finally, EA at T4 mediated the longitudinal association of fear disorders at T2 with distress disorders at T6 as well as of distress disorders at T2 with fear disorders at T6. These findings suggest that EA scores are more than epiphenomena of emotional disorders and that EA may be conceptualized as a relevant transdiagnostic factor affecting the course and development of comorbidity of emotional disorders.
authors.affiliation: Leiden University and Leiden University Medical Center. Electronic address: Spinhoven@FSW.LeidenUniv.NL.
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.affiliation: Leiden University.
authors.forename: Jolijn
authors.initials: J
authors.lastname: Drost
authors.affiliation: Leiden University.
authors.forename: Mark
authors.initials: M
authors.lastname: de Rooij
authors.affiliation: Leiden University Medical Center.
authors.forename: Albert M
authors.initials: AM
authors.lastname: van Hemert
authors.affiliation: Leiden University Medical Center, University Medical Center Groningen, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam.
authors.forename: Brenda W
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D000368:Aged; D000379:Agoraphobia / Q000523:psychology; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005239:Fear; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: anxiety; comorbidity; depression; experiential avoidance; longitudinal study