Experiential Avoidance and Anxiety Sensitivity: Independent and Specific Associations with Children’s Depression, Anxiety, and Social Anxiety Symptoms

Abstract

Experiential avoidance (EA) is a key component in acceptance and commitment therapy (ACT) theory and research. EA is associated with a wide range of psychopathology in adults including anxiety, in particular social anxiety, and depression, yet little research exists on EA in youth. Anxiety sensitivity (AS), like EA, has been viewed as a form of distress tolerance or emotion regulation. In a sample of 124 children (age 10 to 12), this study examined the independent and specific relations of EA and AS to children's depression, anxiety, and social anxiety symptoms, both before and after controlling for comorbid symptoms. EA and AS had independent associations with each of children's depression, anxiety, and social anxiety; and EA had significantly stronger relations than AS with each of children's social anxiety and anxiety. After controlling for depression, only EA (and not AS) was uniquely related to both children's anxiety and social anxiety. After controlling for anxiety and social anxiety, only AS (and not EA) was uniquely related to depression. After controlling for depression and social anxiety, neither EA nor AS was significantly related to anxiety. In contrast, after controlling for depression and anxiety, EA (and not AS) showed a significant and unique relation to children's social anxiety. These findings indicate: 1) there are distinctions between EA and AS; 2) EA and AS are overlapping yet independent correlates for each of depression, anxiety and social and anxiety; and 3) EA and AS show some differential relations with children's depression, anxiety, and social anxiety when comorbid symptoms are considered. Theoretical and treatment implications are highlighted.

Differential Relationships of Child Anxiety and Depression to Child Report and Parent Report of Electronic Media Use

“…Alternatively (or in addition), a child’s depression could interfere with them engaging in non-EMU activities, particularly on the weekends, with EMU potentially becoming a default activity used to occupy their time. This explanation would be in line with the concept of experiential avoidance, again as described in the introduction [24, 25]. These hypotheses suggest the possibility that modification of EMU might be a useful part of interventions designed to target child depression.…”

“…Anxiety and depression have repeatedly been linked to people’s levels of experiential avoidance, defined as the effort to suppress unwanted emotions and experiences, while not changing the emotions and experiences themselves. For example, Epkins defines experiential avoidance as involving “engaging in emotion regulation strategies or behaviors aimed to suppress, avoid, or escape undesirable thoughts, emotions, physical bodily sensations, or other unpleasant private experiences” [24]. Venta et al found an association between experiential avoidance and anxiety in inpatient adolescents, with anxiety associated with experiential avoidance even when controlling for depression [25].…”

“…Venta et al found an association between experiential avoidance and anxiety in inpatient adolescents, with anxiety associated with experiential avoidance even when controlling for depression [25]. Epkins also found that experiential avoidance correlated with child depression, as well as with anxiety and social anxiety even when controlling for depression [24]. This link between anxiety and avoidance raises the possibility that EMU could be a way that anxious children, and potentially also depressed children, engage in experiential avoidance.…”

Experiential Avoidance and Cognitive Emotion Regulation Strategies as the Mediators in the Relationship Between Mindfulness and Social Anxiety Disorder Symptoms

“…This finding is in line with studies that show that anxiety disorders are both characterized and maintained by experiential avoidance (Panayiotou, Karekla & Panayiotou, 2104;Epkins, 2016) and is consistent with study results that mindful awareness may result in lower experiential avoidance (Weinrib, 2011). Thus, increased mindfulness is related with decreased experiential avoidance, which, in turn, is associated with lower social anxiety symptoms.…”

“…Previous studies show that adults with SAD, in comparison with a healthy group, reported more experiential avoidance even after controlling for the presence of other comorbid anxiety disorders and depression (Kashdan et al, 2013;Epkins, 2016). Experiential avoidance can be described as a pro-S cess that occurs when people are unwilling to stay in contact with unpleasant inner experience (Cunha, Galhardo & Pinto-Gouveia, 2016).…”