Aversive Reactivity: A Transdiagnostic Functional Bridge Between Neuroticism and Avoidant Behavioral Coping

Abstract

Aversive reactivity to negative affect has been described as a transdiagnostic mechanism that links distal temperamental vulnerabilities to clinically relevant behaviors. However, the abundance of constructs reflecting aversive reactivity has resulted in a proliferation of models that may ultimately be redundant. We performed a circumscribed review of studies measuring associations between six constructs – anxiety sensitivity, experiential avoidance, distress intolerance, intolerance of uncertainty, thought-action fusion, and negative urgency – and ten relevant coping behaviors. Results suggested that most constructs were measured in relation to a limited number of coping behaviors. Additionally, constructs were most often measured in isolation, rather than with similar constructs. Implications and suggestions for future research and treatment are discussed.

Integrating mindfulness into the extended process model of emotion regulation: The dual-mode model of mindful emotion regulation.

“…For example, a client who previously had difficulty engaging in interpersonal interactions because of social anxiety may show progress behaviorally (i.e., spending more time with others) even without a reduction of feelings of anxiety. This is also consistent with propositions that reducing maladaptive regulatory behaviors may be more important than increasing use of adaptive ones (Aldao et al, 2014;Hoorelbeke et al, 2016;Semcho et al, 2023;Southward et al, 2023;Swerdlow et al, 2020).…”

“…While findings are mixed, there is also evidence indicating that mindfulness training impacts anticipation and response to rewards (Garland, Froeliger, & Howard, 2015; Hafenbrack & Vohs, 2018; Kirk et al, 2015). Additionally, equanimity is likely to reduce maladaptive emotional beliefs (e.g., that emotions are bad, harmful, or uncontrollable) and aversive reactivity which can impede acting on emotion regulation goals or lead to selection of maladaptive strategies (Delgado et al, 2010; Ford & Gross, 2018, 2019; Karnaze & Levine, 2018, 2020; Kneeland et al, 2016; Mennin & Fresco, 2010; Predatu et al, 2020a; Semcho et al, 2023). Thus, we post that equanimity mostly affects the valuation and action components across stages of the EPM; the components which most rely on cognitive appraisals, emotional beliefs, and meta-emotion.…”

Do Unified Protocol modules exert general or unique effects on anxiety, depression, and transdiagnostic targets?

“…These findings suggest all UP modules lead to similar levels of change in cognitive flexibility, negative beliefs about emotions, behavioral avoidance, and anxiety sensitivity. The lack of differences across these processes may reflect that all of these processes, including mindfulness, are thought to be specific instantiations of aversive reactions to negative emotions [ 12 , 5 , 50 , 53 , 7 ]. In this model of emotional disorders, elevated levels of neuroticism (i.e., more frequent experiences of negative emotions) are thought to transact with aversive reactions to negative emotions to lead to avoidant behavioral responses that are expressed as symptoms of emotional disorders (e.g., rumination, compulsions, self-harm, etc.…”

The Unified Protocol: Current status, future directions.

“…Some investigators have begun examining this assumption. For example, the Kentucky group (Semcho et al, 2023) conclude in their incisive analysis of these constructs "Thus, although the isolated nature of these constructs has been perpetuated for decades, it is clear that researchers are moving toward more empirical comparisons and integrations of these constructs" (p. 32). But they also note:…”

“…Some investigators have begun examining this assumption. For example, the Kentucky group (Semcho et al, 2023) conclude in their incisive analysis of these constructs “Thus, although the isolated nature of these constructs has been perpetuated for decades, it is clear that researchers are moving toward more empirical comparisons and integrations of these constructs” (p. 32). But they also note:we do not assume that the aversive reactivity constructs are entirely overlapping; for example, anxiety sensitivity may indeed demonstrate incremental power in predicting agoraphobic avoidance.…”