Examining depression symptoms within OCD: the role of experiential avoidance

Abstract

Background: Obsessive compulsive disorder (OCD) and depression commonly co-occur. Past research has evaluated underlying mechanisms of depression in the context of other diagnoses, but few to no studies have done this within OCD. Aims: This study examines the relationships between distress tolerance (DT), experiential avoidance (EA), depression, and OCD symptom severity across intensive/residential treatment (IRT) for OCD. It was hypothesized that all variables would be significantly moderately related and EA would emerge as a potential contributing factor to change in depression and OCD symptoms across IRT for OCD. Method: The sample included 311 participants with a primary diagnosis of OCD seeking IRT. Correlations were performed between all variables at both admission and discharge. A two-step hierarchical regression with change in OCD symptoms and change in DT in the first block and change in EA in the second block examined if change in EA explained change in depression above and beyond change in OCD and DT ability. Results: At both admission and discharge, higher EA, lower DT, and higher OCD symptom severity were significantly associated with more depressive symptoms. Change in EA explained a significant amount of variance in change in depression above and beyond change in OCD symptom severity and change in DT. Conclusions: This study expands past results within an OCD sample, emphasizing EA as an important treatment target in OCD. Future studies could utilize samples from other treatment contexts, use a measure of EA specific to OCD, and utilize a longitudinal model that takes temporal precedence into account.

Transdiagnostic model of psychological factors and sex differences in depression in a large sample of Ecuador

“…Thirdly, the negative effect of loneliness on depression is not only accounted by its role as a powerful stressor of a social nature, as previously suggested ( Hawkley & Cacioppo, 2010 ; Heinrich & Gullone, 2006 ), but also by impairing our ability to deal with stressing adverse events, in line with recent studies ( Hofmann & Hayes, 2019 ). In other words, it seems that loneliness increases the risk of a psychologically inflexible pattern of behavior characterized by seeking to avoid, scape, or control stressful thoughts and feelings despite their harmful consequences or at the expense of more effective and meaningful actions ( Bond et al, 2011 ; Browning, Van Kirk & Krompinger, 2021 ; Levin et al, 2014 ). Moreover, consistent with this interpretation, perceived stress also increases the risk of psychological inflexibility, enhancing the risk of depression; in other words, psychological inflexibility accounted for a significant part of the impact of perceived stress on depression.…”

Exploring the clinical utility of choice blindness: Generalization of effects and necessity of deception.

“…Unsurprisingly, interventions that reduce experiential avoidance also decrease depressive symptoms. Changes in experiential avoidance, for example, explained reductions in depressive symptoms following treatment for OCD (Browning et al, 2022). Similarly, experiential avoidance partly explained the effects of a mindfulness and self-compassion intervention on depressive symptoms (Yela et al, 2022), and another study (Zeifman et al, 2020) reported that decreases in avoidance following psychedelic use were related to lower depressive symptoms and suicidality.…”

The relationship between sleep disturbance and obsessive– compulsive symptoms: the mediation of repetitive negative thinking and the moderation of experiential avoidance

“…Overall, this indicates that sleep disturbance may aggravate OCS and impede its recovery, where interventions for sleep disturbance may decrease OCS. However, we should notice that higher OCD symptom severity were was significantly associated with more depressive symptoms in a clinical sample, so depression needs to be controlled when examining the relationship between sleep disturbance and OCS ( Browning et al, 2021 ).…”