The predictive value of Approach and Avoidance tendencies on the onset and course of depression and anxiety disorders

Abstract

BackgroundTrait and automatic approach‐avoidance (AA) tendencies are central concepts in research on affective disorders. We longitudinally examined the associations of trait and automatic AA tendencies with the risk of onset and chronicity of anxiety and depressive disorders.MethodsParticipants were subdivided into those with (n = 766) versus without (n = 1,636) a current anxiety or depression diagnosis at baseline. Clinical diagnoses were reassessed after 2‐year follow‐up. Automatic AA tendencies in reaction to facial expressions were assessed using the Approach‐Avoidance Task, whereas self‐reported trait AA tendencies were assessed using the Behavioral Inhibition System and the Behavioral Activation System scales. Analyses were adjusted for socio‐demographics (basic adjustment) and for severity and history of psychopathology (full adjustment).ResultsStronger trait avoidance tendencies predicted both increased risk of onset and increased risk of a chronic course of anxiety disorders after full adjustment (Odds ratioonset = 1.55, P < .001, and Odds ratiochronicity = 1.31, P = .03). The associations between stronger trait avoidance tendencies and increased risk of onset and chronicity of depressive disorders were no longer significant after full adjustment. In contrast, trait approach tendencies and automatic AA tendencies were not related to onset or chronicity of disorders.ConclusionsIncreased trait avoidance tendencies are a risk factor for affective disorders in general, with possibly a slightly more pronounced role in anxiety than depressive disorders. This underlines the importance of addressing trait avoidance tendencies in both the treatment and aftercare of affective disorders.

Dispositional negativity, cognition, and anxiety disorders: An integrative translational neuroscience framework

“…Dispositional negativity is robustly associated with some of the most common and burdensome mental illnesses, including anxiety disorders, depression, and co-morbid substance abuse (e.g., Castellanos-Ryan et al, 2016; Davis et al, 2018; Hayes, Osborn, Lewis, Dalman, & Lundin, 2017; Hengartner, Tyrer, Ajdacic-Gross, Angst, & Rossler, 2018; Kendler et al, in press; Navrady et al, 2017; Paulus, Backes, Sander, Weber, & von Gontard, 2015; Seeboth & Mottus, 2018; Shackman et al, 2016c). Longitudinal work shows that individuals with elevated levels of dispositional negativity are more likely to develop internalizing (i.e., anxiety and mood) disorders in the future (e.g., Buzzell et al, 2017; Clark, Durbin, Hicks, Iacono, & McGue, in press; Goldstein, Kotov, Perlman, Watson, & Klein, 2018; Klein & Mumper, 2018; Luan et al, in press; Struijs et al, 2018; Wichstrom, Penelo, Rensvik Viddal, de la Osa, & Ezpeleta, 2018; Zinbarg et al, 2016). The magnitude of these prospective associations is substantial.…”

Cognitive Avoidance Questionnaire: Factor structure and psychometric properties.

“…From the perspective of the classification of coping strategies, these results were as expected, given that logical analysis and positive reappraisal are considered to be approach styles, understood as cognitive or behavioral efforts focused on handling a stressor, and thus potentially opposed to avoidance strategies (Moos, 1993). Moreover, although cognitive avoidance strategies have been associated with psychopathology (e.g., Barajas et al, 2017: Hayes, 2016Schäfer et al, 2017;Struijs et al, 2018), it should be taken into account that their use depends, among other elements, on the types of the stressors and individual and generational differences (e.g., Chen, Peng, Xu, & O´Brain, 2018;Nieto et al, 2020).…”

“…Avoidance, understood as the tendency to escape private internal experiences such as emotions, thoughts, and memories, is a natural reaction that is critical to individuals' survival (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996). However, this response may be maladaptive when excessive or unnecessary, being considered a risk factor for developing and maintaining emotional disorders, such as depressive and anxiety disorders (Barajas, Garra, & Ros, 2017;Schäfer, Naumman, Holmes, Tuschen-Caffier, & Samson, 2017;Struijs et al, 2018). In relation to such approaches, since the emergence of the "Third Wave" of therapies, much attention has been focused on the role of cognitive, behavioral and emotional avoidance in psychopathology (Eifert & Forsyth, 2005;Hayes, 2016).…”

To Approach or to Avoid? Motivation Differentially Mediates the Effect of Hardiness on Depressive Symptoms in Chinese Military Personnel

“…Therefore, the role of behavioral activation, especially the persistent pursuit of goals, should be emphasized during hardiness training of army soldiers. However, stronger trait avoidance motivation is also associated with increased risk of onset and chronicity of depressive disorders [24], which suggested the significance of inflexible coping strategies in less hardy individuals.…”

“…In contrast, BAS sensitivity played a protective role in working against maladaptive avoidant coping (e.g., gambling and alcohol use) [20]. Depression is characteristic of reduced BAS [21–23] and increased BIS [23, 24], or the combination of both [25]. Presumably, a coping style based on weak motivation to seek reward (lower BAS) and strong motivation to avoid punishment (higher BIS) may lead to increased feelings of depression.…”