Experiential avoidance, coping, and anxiety in students from a public university in Lima
Abstract
Experiential avoidance (EA)—or psychological (in)flexibility—is a central concept in contextual therapies, and it has been proposed as a transdiagnostic dimension of psychopathology. We intended to test whether EA and other coping strategies independently predict both state and trait-anxiety. We administered a set of measures (the AAQ-II, a modified version of the Brief COPE, and the STAI) to 284 undergraduates from a public university in Lima, Peru. Results showed that EA, lack of problem solving, self-blame, and substance use were all significantly related to state and trait-anxiety. However, after submitting these variables to multiple regression analyses, only EA, lack of problem solving, and self-blame remained significant predictors of trait-anxiety; of these, only EA made a significant improvement to the model (ΔR² = .16). On the other hand, none of the variables under study were significant predictors of state-anxiety. We concluded that the effort to avoid unpleasant thoughts and emotions constitutes a central aspect of trait-anxiety. We discussed these findings in light of previous studies, and gave suggestions for future research.
Downloads
References
Barajas, S. (2013). Evitación cognitivo-conductual, aceptación psicológica y mindfulness en la psicopatología de la ansiedad y la depresión (Tesis doctoral, Universidad de Castilla, La Mancha, España). Recuperada de https://ruidera.uclm.es/xmlui/handle/10578/3794
Barajas, S. (2015). Evitación y psicopatología: Un estudio a través de una tarea experimental y su relación con medidas de autoinforme. Revista de Psicopatología y Psicología Clínica, 1(1), 63-73. doi: 10.5944/rppc.vol.1.num.1.2015.14409
Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic. Nueva York: The Guilford Press.
Barreda, D. (2012). Depresión y estilos de afrontamiento al estrés en pacientes con enfermedad cerebrovascular. Revista IIPSI, 15(2), 203-216.
Bluett, E. J., Homan, K. J., Morrison, K. L., Levin, M. E. y Twohig, M. P. (2014). Acceptance and commitment therapy for anxiety and OCD spectrum disorders: An empirical review. Journal of Anxiety Disorders, 28(6), 612-624. doi: 10.1016/j.janxdis.2014.06.008
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., Waltz, T. y Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42(4), 676-688. doi: 10.1016/j.beth.2011.03.007
Canty, A. y Ripley, B. (2016). boot: Bootstrap R (S-Plus) Functions. Paquete de R, versión 1.3-18. https://CRAN.R-project.org/package=boot
Cardona-Arias, J. A., Pérez-Restrepo, D., Rivera-Ocampo, S., Gómez-Martínez, J. y Reyes, A. (2015). Prevalencia de ansiedad en estudiantes universitarios. Diversitas: Perspectivas en Psicología, 11(1), 79-89. doi: 10.15332/s1794-9998.2015.0001.05
Carver, C. S. (1997). You want to measure coping but your protocol's too long: Consider the brief COPE. International Journal of Behavioral Medicine, 4(1), 92-100. doi: 10.1207/s15327558ijbm0401_6
Cassaretto, M., Chau, C., Oblitas, H. y Valdez, N. (2003). Estrés y afrontamiento en estudiantes de psicología. Revista de Psicología de la PUCP, 21(2), 363-392.
Castellanos, M.T., Guarnizo, C.A. y Salamanca, Y. (2011). Relación entre niveles de ansiedad y estrategias de afrontamiento en practicantes de psicología de una universidad colombiana. International Journal of Psychological Research, 4(1), 50-57.
Chapi, J. L. (2012). Satisfacción familiar, ansiedad y cólera-hostilidad en adolescentes de dos instituciones educativas estatales de Lima. (Tesis de licenciatura, Universidad Nacional Mayor de San Marcos, Lima). Recuperada de http://cybertesis.unmsm.edu.pe/handle/cybertesis/585
Chawla, N. y Ostafin, B. (2007). Experiential avoidance as a functional dimensional approach to psychopathology: An empirical review. Journal of Clinical Psychology, 63(9), 871-890. doi: 10.1002/jclp.20400
Clark, L. A. y Watson, D. (1991). Tripatite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100(3), 316-336. doi: 10.1037/0021-843X.100.3.316
Creswell, J. W. (2012). Educational research: Planning, conducting, and evaluating quantitative and qualitative research. Boston: Pearson.
Costa, J. y Pinto-Gouveia, J. (2011). The mediation effect of experiential avoidance between coping and psychopathology in chronic pain. Clinical Psychology and Psychotherapy, 18(1), 34-47. doi: 10.1002/cpp.699
Domínguez, S., Villegas, G., Sotelo, N. y Sotelo, L. (2012). Revisión psicométrica del Inventario de Ansiedad Estado-Rasgo (IDARE) en una muestra de universitarios de Lima Metropolitana. Revista Peruana de Psicología y Trabajo Social, 1(1), 45-54.
Egúsquiza-Vásquez, K. (2015). Aplicación de la Terapia de Aceptación y Compromiso (ACT) a la conducta inapetente: Un estudio de caso. Interacciones, 1(2), 93-104. doi: 10.24016/2015.v1n2.9
Eifert, G. H. y Forsyth, J. P. (2005). Acceptance and commitment therapy for anxiety disorders: A practitioner's treatment guide to using mindfulness, acceptance, and values-based behavior change strategies. Oakland: New Harbinger.
Eifert, G. H. y Heffner, M. (2003). The effects of acceptance versus control contexts on avoidance of panic-related symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 34(3-4), 293-312. doi: 10.1016/j.jbtep.2003.11.001
Fabrigar, L. R. y Wegener, D. T. (2012). Exploratory factor analysis. Nueva York: Oxford University Press.
Fledderus, M., Bohlmeijer, E. T. y Pieterse, M. E. (2010). Does experiential avoidance mediate the effects of maladaptive coping styles on psychopathology and mental health? Behavior Modification, 34(6), 503-519. doi: 10.1177/0145445510378379
Fletcher, T. D. (2012). QuantPsyc: Quantitative Psychology Tools. Paquete de R, versión 1.5. https://CRAN.R-project.org/package=QuantPsyc
Forman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D. y Geller, P. A. (2007). A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression. Behavior Modification, 31(6), 772-799. doi: 10.1177/0145445507302202
Forsyth, J. P., Barrios, V. y Acheson, D. (2007). Exposure therapy and cognitive interventions for the anxiety disorders: Overview and newer third-generation perspectives. En D. C. S. Richard y D. Lauterbach (Eds.), Handbook of exposure therapies (pp. 61-108). Nueva York: Academic Press.
Gámez, W., Chmielewski, M., Kotov, R., Ruggero, C., Suzuki, N. y Watson, D. (2014). The Brief Experiential Avoidance Questionnaire: Development and initial validation. Psychological Assessment, 26(1), 35-45. doi: 10.1037/a0034473
Gantiva, C. A., Luna, A., Dávila, A. M. y Salgado, M. J. (2010). Estrategias de afrontamiento en personas con ansiedad. Psychologia, 4(1), 63-72.
Gross, J. y Ligges, U. (2015). nortest: Tests for Normality. Paquete de R, versión 1.0-4. https://CRAN.R-project.org/package=nortest
Guinther, P. M. y Dougher, M. J. (2015). The clinical relevance of stimulus equivalence and relational frame theory in influencing the behavior of verbally competent adults. Current Opinion in Psychology, 2, 21-25. doi: 10.1016/j.copsyc.2015.01.015
Hayes, S. C., Strosahl, K. D. y Wilson, K. G. (2014). Terapia de aceptación y compromiso. Proceso y práctica del cambio consciente (Mindfulness). Bilbao: Desclée de Brouwer.
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. y Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152-1168. doi: 10.1037/0022-006X.64.6.1152
Jose, P. E. (2013). Doing statistical mediation and moderation. Nueva York: The Guilford Press.
Karekla, M., Forsyth, J. P. y Kelly, M. M. (2004). Emotional avoidance and panicogenic responding to a biological challenge procedure. Behavior Therapy, 35(4), 725-746. doi: 10.1016/S0005-7894(04)80017-0
Karekla, M. y Panayiotou, G. (2011). Coping and experiential avoidance: Unique or overlapping constructs? Journal of Behavior Therapy and Experimental Psychiatry, 42(2), 163-170. doi: 10.1016/j.jbtep.2010.10.002
Kashdan, T. B., Barrios, V., Forsyth, J. P. y Steger, M. F. (2006). Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behavior Research and Therapy, 44, 1301-1320. doi: 10.1016/j.brat.2005.10.003
Lazarus, R. S. y Folkman, S. (1986). Estrés y procesos cognitivos. Barcelona: Martínez Roca.
Levitt, J. T., Brown, T. A., Orsillo, S. M. y Barlow D. H. (2004). The effects of acceptance versus suppression of emotion on subjective and psychophysiological response to carbon dioxide challenge in patients with panic disorder. Behavior Therapy, 35(4), 747-766. doi: 10.1016/S0005-7894(04)80018-2
Lorenzo-Seva, U. y Ferrando, P. J. (2006). FACTOR: A computer program to fit the exploratory factor analysis model. Behavioral Research Methods, Instruments and Computers, 38(1), 88-91. doi: 10.3758/BF03192753
Lovibond, P. F. y Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335-343. doi: 10.1016/0005-7967(94)00075-U
Luciano, C. (2016). Evolución de ACT. Análisis y Modificación de Conducta, 42(165-166), 3-14.
Luciano, C., Gutiérrez, O. y Rodríguez, M. (2005). Análisis de los contextos verbales en el trastorno de evitación experiencial y en la terapia de aceptación y compromiso. Revista Latinoamericana de Psicología, 37(2), 333-358.
Morán, C., Landero, R. y González, M. T. (2010). COPE-28: un análisis psicométrico de la versión en español del Brief COPE. Universitas Psychologica, 9(2), 543-552.
Morón, R. (2005). Aplicación de la terapia de aceptación y compromiso a un caso de crisis de angustia con agorafobia: Un estudio de caso. Análisis y Modificación de Conducta, 31(138), 479-498.
Orsillo, S. M., Roemer, L. y Holowka, D. W. (2005). Acceptance-based behavioral therapies for anxiety: Using acceptance and mindfulness to enhance traditional cognitive-behavioral approaches. En S. M. Orsillo y L. Roemer (Eds.), Acceptance and mindfulness-based approaches to anxiety: Conceptualization and treatment (pp. 3-35). Nueva York: Springer.
Panayiotou, G., Karekla, M. y Mete, I. (2014). Dispositional coping in individuals with anxiety disorder symptomatology: Avoidance predicts distress. Journal of Contextual Behavioral Science, 3(4), 314-321. doi: 10.1016/j.jcbs.2014.07.001
Patrón, F. (2010). La evitación experiencial y su medición por medio del AAQ-II. Enseñanza e Investigación en Psicología, 15(1), 5-19.
Patrón, F. (2013). La evitación experiencial como dimensión funcional de los trastornos de depresión, ansiedad y psicóticos. Journal of Behavior, Health y Social Issues, 5(1), 85-95. doi: 10.5460/jbhsi.v5.1.38728
Pedrelli, P., Nyer, M., Yeung, A., Zulauf, C. y Wilens, T. (2015). College students: Mental health problems and treatment considerations. Academic Psychiatry, 39(5), 503-511. doi: 10.1007/s40596-014-0205-9
Piemontesi, S. E., Heredia, D. E., Furlan, L. A., Sánchez-Rosas, J. y Martínez, M. (2012). Ansiedad ante los exámenes y estilos de afrontamiento ante el estrés académico en estudiantes universitarios.Anales de Psicología, 28(1), 89-96.
R Core Team (2016). R: A language and environment for statistical computing (versión 3.3.1) [Programa de computadora]. Viena: R Foundation for Statistical Computing. https://www.R-project.org/
Rosenthal, R. (1991). Meta-analytic procedures for social research. Newbury Park: SAGE.
Sánchez, H. y Reyes, C. (2009). Metodología y diseños en la investigación científica. Lima: Visión Universitaria.
Sandín, B. y Chorot, P. (2009). Concepto y categorización de los trastornos de ansiedad. En A. Belloch, B. Sandín y F. Ramos (Coords.), Manual de psicopatología. Vol. 2 (pp. 43-63). Madrid: McGraw-Hill/Interamericana.
Schmalz, J. E. y Murrell, A. R. (2010). Measuring experiential avoidance in adults: The Avoidance and Fusion Questionnaire. International Journal of Behavioral Consultation and Therapy, 6(3), 198-213. doi: 10.1037/h0100908
Sharp, K. (2012). A review of acceptance and commitment therapy with anxiety disorders. International Journal of Psychology and Psychological Therapy, 12(3), 359-372.
Spielberger. C. y Diaz-Guerrero, R. (2007). IDARE: Inventario de Ansiedad Rasgo-Estado. México: Manual Moderno.
Swain, J., Hancock, K., Hainsworth, C. y Bowman, J. (2013). Acceptance and Commitment Therapy in the treatment of anxiety: A systematic review. Clinical Psychology Review, 33(8), 965-978. doi: 10.1016/j.cpr.2013.07.002
Törneke, N. (2015). Aprendiendo TMR: Una introducción a la Teoría del Marco Relacional y sus aplicaciones clínicas. Jaén: MICPSY.
Torrejón, C. S. (2011). Ansiedad y afrontamiento en universitarios migrantes (Tesis de licenciatura, Pontifica Universidad Católica del Perú, Lima). Recuperada de http://tesis.pucp.edu.pe/repositorio/handle/123456789/68
Twohig, M. P., Masuda, A., Varra, A. A. y Hayes, S. C. (2005). Acceptance and commitment therapy as a treatment for anxiety disorders. En S. M. Orsillo y L. Roemer (Eds.), Acceptance and mindfulness-based approaches to anxiety: Conceptualization and treatment (pp. 101-129). Nueva York: Springer.
Vera-Villarroel, P., Celis-Atenas, K., Córdova-Rubio, N., Buena-Casal, G. y Spielberger, C. D. (2007). Preliminary analysis and normative data of the State-Trait Anxiety Inventory (STAI) in adolescent and adults of Santiago, Chile. Terapia Psicológica, 25(2), 155-162. doi: 10.4067/S0718-48082007000200006
Wilson, K. G., y Luciano, M. C. (2002). Terapia de aceptación y compromiso (ACT). Un tratamiento conductual orientado a los valores. Madrid: Pirámide.
Wolgast, M. (2014). What does the Acceptance and Action Questionnaire (AAQ-II) really measure? Behavior Therapy, 45(6), 831-839. doi: 10.1016/j.beth.2014.07.002
Copyright (c) 2017 Interacciones
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain the copyright and give the journal the right of the first publication and that they can edit it, reproduce it, distribute it, exhibit it and communicate it in the country and abroad through printed and digital media.
The digital version of the journal is registered under a Creative Commons license (Under Creative Commons License): Attribution 4.0 International (CC BY 4.0). Therefore, this work can be reproduced, distributed and publicly communicated in digital format, provided that the names of the authors and Interacciones.
Therefore, it is established that authors can make other independent and additional behavioural agreements for the non-exclusive distribution of the version of the article published in this journal (eg, include it in institutional repositories or publish it in a book) as long as it is clearly indicated that the work was published for the first time in this journal.
