Relationships among Stress, Experiential Avoidance and Depression in Psychiatric Patients

Abstract

This study investigated the specific association of stressful life events (SLE) and experiential avoidance (EA) with depression in patients with mental disorders. It also analyzed the possible mediating role of depression in the relation of EA to well-being and life satisfaction. A total of 147 patients (mean age = 40.16 years) diagnosed with anxiety, mood or adjustment disorder were recruited from a mental health centre. They completed measures of SLE, EA, depression, well-being and life satisfaction. Regression analyses showed that SLE and EA were positively related to depression (R 2 = .45), although the contribution made by EA was higher (β = .61, p < .001) than the one made by SLE (β = .19, p < .01). Bootstrap mediation analyses revealed that there was an indirect effect from EA to physical well-being (B = -4.52, SE = .70, p < .001, 95% CI [-6.03, -3.20]) and satisfaction (B = -.14, SE = .02, p < .001, 95%, CI [-.19 -.09]) through depression. This indirect effect was less consistently supported with respect to emotional well-being (B = -3.33, SE = .48, p < .001, 95%, CI [-4.30, -2.41]). These findings give support to the hypothesis that EA could be an important factor contributing to depression in patients with mental disorders. The results also provide evidence that depression seems to play an important mediational role when considering the negative impact that EA exerts on patients´ well-being and satisfaction.

Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms

“…We applied the following mediation model: (a) time (months) as the independent variable, (b) "process variables at month j" as potential mediators, and (c) "outcome variable at month j" as the dependent variable. Multilevel mediation analysis was conducted in PASW 25.0 (IBM) using the "MLmed" macro by Rockwood and Hayes (2017) on an intention-to-treat basis. Different independent multilevel analyses were conducted where potential mediators were estimated individually.…”

“…Acceptance is an alternative to experiential avoidance, which is an unwillingness to be in contact with inner experiences that manifests itself through behavioral strategies aiming to reduce or avoid them. Experiential avoidance has been identified as an important factor contributing to depression (Cribb et al, 2006;Shallcross et al, 2010;Rueda and Valls, 2016) and commonly takes the form of rumination, where deliberate efforts are made to think through it (Zettle, 2007).…”

Stress moderates the relationships between problem-gambling severity and specific psychopathologies

“…Stress has been defined (Lazarus, 1996) as an event that, “occurs when an individual perceives that the demands of an external situation are beyond his or her perceived ability to cope with them.” Recently Blaszczynski and Nower (2017) validated a new etiological instrument to assess people with gambling problems, in which stress-coping and childhood maltreatment variables represent two important factors that assist in identifying different subgroups of individuals with pathological gambling, highlighting the importance that stress could have in the pathophysiology of the disorder. The association of stressful life events with psychiatric disorders has been widely studied, especially for depressive disorders (Tao et al, 2011; Anders et al, 2012; Rueda and Valls, 2016). Moreover, stress is a well-known factor that contributes to the development, maintenance and relapse of several externalizing disorders, including in addictions the use of alcohol (King et al, 2003; Dawson et al, 2005; Keyes et al, 2012; Young-Wolff et al, 2012) and drugs (Blanco et al, 2014; Myers et al, 2014).…”

Psychometric evaluation of the Brief Experiential Avoidance Questionnaire among treatment-seeking veterans with posttraumatic stress disorder.

“…It has been proposed as an underlying mechanism of many psychological phenomena (Hayes et al, 1996) and as a transdiagnostic mechanism. EA has been implicated in a variety of psychological problems, including depression (Barnhofer, Brennan, Crane, Duggan, & Williams, 2014; Rueda & Valls, 2016), anxiety (Roemer, Salters, Raffa, & Orsillo, 2005), and posttraumatic stress disorder (PTSD; Marx & Sloan, 2005). By definition, the diagnosis of PTSD requires endorsement of avoidance symptoms.…”