The transdiagnostic model of worry: The mediating role of experiential avoidance

Akbari, Mehdi; Khanipour, Hamid

doi:10.1016/j.paid.2018.07.011

Cited by 19 publications

(12 citation statements)

References 56 publications

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“…Supporting this view, emotional exhaustion–a component of emotional tension as measured in the present study–has been previously found to be a common risk factor for burnout and posttraumatic stress disorder following triggering circumstances [ 77 ], hyperacusis in women following triggering circumstances [ 78 ] and chronic pain [ 79 , 80 ]. Similarly, worry has been identified as a transdiagnostic construct common to depressive symptoms, anxiety [ 81 , 82 ] and pain [ 3 ] possibly serving a psychological function to reduce negative affect associated with underlying interpretational thought-memory-interactions [ 83 ].…”

Section: Discussionmentioning

confidence: 99%

Two birds with one stone.–Addressing depressive symptoms, emotional tension and worry improves tinnitus-related distress and affective pain perceptions in patients with chronic tinnitus

et al. 2021

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Background Psychological factors link the co-occurrence of tinnitus-related distress and pain perceptions in patients with chronic tinnitus. Objective This study examines, if treatment-related changes in these factors ameliorate both tinnitus-related distress and pain perceptions in a sample of patients with chronic tinnitus. Methods N = 1238 patients with chronic tinnitus provided pre- and post-treatment ratings of tinnitus-related distress and affective or sensory pain perceptions alongside measures of depressive symptoms and perceived stress. Treatment comprised an intensive tinnitus-specific multimodal treatment program. Using serial indirect-effects analyses, we examined association patterns between baseline values and change rates of those variables that were found to respond to treatment. Results Small effect sizes emerged for changes in tinnitus-related distress, affective (but not sensory) pain perceptions, depressive symptoms, emotional tension and worry. At pre- or post-treatment respectively, baseline values and change rates intercorrelated. Across timepoints, (1) baseline tinnitus-related distress and affective pain perceptions were positively associated with improvements in tinnitus-related distress, affective pain perceptions and depressive symptoms. (2) Baseline depressive symptoms or emotional tension mediated positive associations between baseline tinnitus-related distress and improvement in affective pain perceptions. (3) Change in depressive symptoms mediated the effect of baseline tinnitus-related distress on change in affective pain perceptions–partly through associated change in emotional tension or worry. Mood-independent aspects of emotional tension were negatively associated with improvement in affective pain perceptions. Conclusions Depressive symptoms, emotional tension and worry emerge as key predictors of treatment response and transdiagnostic treatment targets for alleviating tinnitus-related distress and functionally associated affective pain perceptions.

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Section: Discussionmentioning

confidence: 99%

Two birds with one stone.–Addressing depressive symptoms, emotional tension and worry improves tinnitus-related distress and affective pain perceptions in patients with chronic tinnitus

et al. 2021

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“…Finally, in a non-clinical sample, EA mediated the relations between worry and several constructs that are also associated with the development of emotional disorders (intolerance of uncertainty, metacognitive beliefs, and negative emotional schemas; Akbari & Khanipour, 2018).…”

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confidence: 91%

Experiential Avoidance as a Mechanism of Change Across Cognitive-Behavioral Therapy in a Sample of Participants with Heterogeneous Anxiety Disorders

et al. 2019

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“…Surprisingly, there is a dearth of research testing whether fears of negative evaluation, physical sensations, or uncertainty predict greater or less use of EA in individuals with SAD symptoms. However, indirect evidence suggests that each may predict EA in the context of the other disorders, such as symptoms of eating disorders (Espel-Huynh et al, 2019) and generalized anxiety disorder (Akbari & Khanipour, 2018). Thus, building on the present study, a meaningful follow-up could explore how these constructs (i.e., fears of negative evaluation, physical symptoms, and uncertainty) work together to predict more or less use of EA for individuals with SAD symptoms.…”

Section: Discussionmentioning

confidence: 84%

Evaluating Mechanisms: Mapping Weekly Dynamics between Experiential Avoidance and SAD Symptoms

Sarfan

Magee

Clerkin

2021

J Psychopathol Behav Assess

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Widely-used, empirically-supported treatments focus on reducing experiential avoidance (EA) as a mechanism of social anxiety disorder (SAD) symptom change. However, little is known about how EA and SAD symptoms bidirectionally interrelate from session to session, or throughout the course of an intervention—a gap that raises significant theoretical and clinical questions about the mechanistic role of EA. Participants (N = 78) with elevated EA and SAD symptoms completed a 3-session pilot intervention (Approach-Avoidance Task training plus psychoeducation) designed to target EA. Bivariate latent change score modeling was then used to map the bidirectional, temporal interrelationships between EA and SAD symptoms from session to session. Analyses accounted for the overall trajectory of change in both variables (i.e., EA and SAD) and both variables’ preceding measurement. Findings suggested that changes in SAD symptoms preceded and predicted changes in EA from session to session. Contrary to hypotheses, this effect was not bidirectional, as changes in EA did not precede and predict changes in SAD symptoms from session to session. The use of a relatively small analogue sample limit the external validity of the present findings. Nevertheless, these novel findings advance our understanding of the dynamic interrelationships between EA and SAD symptoms throughout treatment. Moreover, given that many leading treatments target EA, this study highlights a need for future work to continue evaluating whether EA is indeed a mechanism of SAD symptom change.

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The transdiagnostic model of worry: The mediating role of experiential avoidance

Cited by 19 publications

References 56 publications

Two birds with one stone.–Addressing depressive symptoms, emotional tension and worry improves tinnitus-related distress and affective pain perceptions in patients with chronic tinnitus

Two birds with one stone.–Addressing depressive symptoms, emotional tension and worry improves tinnitus-related distress and affective pain perceptions in patients with chronic tinnitus

Experiential Avoidance as a Mechanism of Change Across Cognitive-Behavioral Therapy in a Sample of Participants with Heterogeneous Anxiety Disorders

Evaluating Mechanisms: Mapping Weekly Dynamics between Experiential Avoidance and SAD Symptoms

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