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21-11-2019 | Original Article

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

Auteurs: Elizabeth H. Eustis, Nicole Cardona, Maya Nauphal, Shannon Sauer-Zavala, Anthony J. Rosellini, Todd J. Farchione, David H. Barlow

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 2/2020

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Abstract

Despite the substantial evidence that supports the efficacy of cognitive-behavioral therapy for the treatment of anxiety and related disorders, our understanding of mechanisms of change throughout treatment remains limited. The goal of the current study was to examine changes in experiential avoidance across treatment in a sample of participants (N = 179) with heterogeneous anxiety disorders receiving various cognitive-behavioral therapy protocols. Univariate latent growth curve models were conducted to examine change in experiential avoidance across treatment, followed by parallel process latent growth curve models to examine the relationship between change in experiential avoidance and change in anxiety symptoms. Finally, bivariate latent difference score models were conducted to examine the temporal precedence of change in experiential avoidance and change in anxiety. Results indicated that there were significant reductions in experiential avoidance across cognitive-behavioral treatment, and that change in experiential avoidance was significantly associated with change in anxiety. Results from the latent difference score models indicated that change in experiential avoidance preceded and predicted subsequent changes in anxiety, whereas change in anxiety did not precede and predict subsequent changes in experiential avoidance. Taken together, these results provide additional support for reductions in experiential avoidance as a transdiagnostic mechanism in cognitive-behavioral therapy.
Voetnoten
1
Number of treatment sessions in the Unified Protocol condition were based on the recommended number of sessions in each SDP to control for number of sessions across active treatment conditions.
 
2
Additional univariate LGMs examined reductions in EA (MEAQ total score and MEAQ-DA subscale) within the Unified Protocol and Single Disorder Protocol conditions separately, and indicated that there were significant reductions in EA (MEAQ total score and MEAQ-DA) within each treatment condition, and no significant differences between the Unified Protocol and Single Disorder Protocol conditions.
 
Literatuur
go back to reference Barlow, D. H., & Craske, M. G. (2006). Mastery of your anxiety and panic (4th ed.). Oxford: Oxford University Press.CrossRef Barlow, D. H., & Craske, M. G. (2006). Mastery of your anxiety and panic (4th ed.). Oxford: Oxford University Press.CrossRef
go back to reference Barlow, D. H., Farchione, T. J., Sauer-Zavala, S., Latin, H. M., Ellard, K. K., Bullis, J. R., et al. (2018). Unified protocol for transdiagnostic treatment of emotional disorders: Workbook (2nd ed.). New York: Oxford University Press. Barlow, D. H., Farchione, T. J., Sauer-Zavala, S., Latin, H. M., Ellard, K. K., Bullis, J. R., et al. (2018). Unified protocol for transdiagnostic treatment of emotional disorders: Workbook (2nd ed.). New York: Oxford University Press.
go back to reference Brown, T. A., & Barlow, D. H. (2014). Anxiety and related disorders interview schedule for DSM-5 (ADIS-5) - adult version: Client interview schedule 5-copy set. Oxford: Oxford University Press. Brown, T. A., & Barlow, D. H. (2014). Anxiety and related disorders interview schedule for DSM-5 (ADIS-5) - adult version: Client interview schedule 5-copy set. Oxford: Oxford University Press.
go back to reference Brown, T. A., DiNardo, P., & Barlow, D. H. (1994). Anxiety disorders interview schedule adult version (ADIS-IV): Client interview schedules. Oxford: Oxford University Press. Brown, T. A., DiNardo, P., & Barlow, D. H. (1994). Anxiety disorders interview schedule adult version (ADIS-IV): Client interview schedules. Oxford: Oxford University Press.
go back to reference Ciarrochi, J., Bilich, L., & Godsell, C. (2010). Psychological flexibility as a mechanism of change in acceptance and commitment therapy. Assessing mindfulness and acceptance processes in clients: Illuminating the theory and practice of change (pp. 51–75). Oakland, CA: Context Press/New Harbinger Publications. Ciarrochi, J., Bilich, L., & Godsell, C. (2010). Psychological flexibility as a mechanism of change in acceptance and commitment therapy. Assessing mindfulness and acceptance processes in clients: Illuminating the theory and practice of change (pp. 51–75). Oakland, CA: Context Press/New Harbinger Publications.
go back to reference Craske, M. G., & Barlow, D. H. (2007). Mastery of your anxiety and panic: Therapist guide. Oxford: Oxford University Press. Craske, M. G., & Barlow, D. H. (2007). Mastery of your anxiety and panic: Therapist guide. Oxford: Oxford University Press.
go back to reference Foa, E. B., Yadin, E., & Lichner, T. K. (2012a). Exposure and response (ritual) prevention for obsessive compulsive disorder: Therapist guide (2nd ed.). Oxford: Oxford University Press.CrossRef Foa, E. B., Yadin, E., & Lichner, T. K. (2012a). Exposure and response (ritual) prevention for obsessive compulsive disorder: Therapist guide (2nd ed.). Oxford: Oxford University Press.CrossRef
go back to reference Foa, E. B., Yadin, E., & Lichner, T. K. (2012b). Treating your OCD with exposure and response (ritual) prevention: Workbook (2nd ed.). New York: Oxford University Press. Foa, E. B., Yadin, E., & Lichner, T. K. (2012b). Treating your OCD with exposure and response (ritual) prevention: Workbook (2nd ed.). New York: Oxford University Press.
go back to reference Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy, second edition: The process and practice of mindful change (2nd ed.). New York: Guilford Press. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy, second edition: The process and practice of mindful change (2nd ed.). New York: Guilford Press.
go back to reference Hope, D. A., Heimberg, R. G., & Turk, C. L. (2006). Managing social anxiety: A cognitive-behavioral therapy approach: Therapist guide (1st ed.). Oxford: Oxford University Press. Hope, D. A., Heimberg, R. G., & Turk, C. L. (2006). Managing social anxiety: A cognitive-behavioral therapy approach: Therapist guide (1st ed.). Oxford: Oxford University Press.
go back to reference Hope, D. A., Heimberg, R. G., & Turk, C. L. (2010). Managing social anxiety: A cognitive-behavioral therapy approach (2nd ed.). New York: Oxford University Press. Hope, D. A., Heimberg, R. G., & Turk, C. L. (2010). Managing social anxiety: A cognitive-behavioral therapy approach (2nd ed.). New York: Oxford University Press.
go back to reference McArdle, J. J., & Nesselroade, J. R. (1994). Using multivariate data to structure developmental change. In The West Virginia University Conferences on Life-Span Developmental Psychology. Life-span developmental psychology: Methodological contributions (pp. 223–267). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc. McArdle, J. J., & Nesselroade, J. R. (1994). Using multivariate data to structure developmental change. In The West Virginia University Conferences on Life-Span Developmental Psychology. Life-span developmental psychology: Methodological contributions (pp. 223–267). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.
go back to reference Meyer, E. C., Kotte, A., Kimbrel, N. A., DeBeer, B. B., Elliott, T. R., Gulliver, S. B., et al. (2019). Predictors of lower-than-expected posttraumatic symptom severity in war veterans: The influence of personality, self-reported trait resilience, and psychological flexibility. Behaviour Research and Therapy,113, 1–8. https://doi.org/10.1016/j.brat.2018.12.005.CrossRefPubMed Meyer, E. C., Kotte, A., Kimbrel, N. A., DeBeer, B. B., Elliott, T. R., Gulliver, S. B., et al. (2019). Predictors of lower-than-expected posttraumatic symptom severity in war veterans: The influence of personality, self-reported trait resilience, and psychological flexibility. Behaviour Research and Therapy,113, 1–8. https://​doi.​org/​10.​1016/​j.​brat.​2018.​12.​005.CrossRefPubMed
go back to reference Muthén, L. K., & Muthén, B. O. (1998). Mplus user’s guide: Statistical analysis with latent variables (7th ed.). Los Angeles, CA: Muthén & Muthén. Muthén, L. K., & Muthén, B. O. (1998). Mplus user’s guide: Statistical analysis with latent variables (7th ed.). Los Angeles, CA: Muthén & Muthén.
go back to reference Roemer, L., & Orsillo, S. M. (2009). Mindfulness- and acceptance-based behavioral therapies in practice. New York: The Guilford Press. Roemer, L., & Orsillo, S. M. (2009). Mindfulness- and acceptance-based behavioral therapies in practice. New York: The Guilford Press.
go back to reference Roemer, L., & Orsillo, S. M. (2014). An acceptance-based behavioral therapy for generalized anxiety disorder. In Clinical handbook of psychological disorders, fifth edition: A step-by-step treatment manual (5th ed., pp. 206–236). New York: The Guilford Press. Roemer, L., & Orsillo, S. M. (2014). An acceptance-based behavioral therapy for generalized anxiety disorder. In Clinical handbook of psychological disorders, fifth edition: A step-by-step treatment manual (5th ed., pp. 206–236). New York: The Guilford Press.
go back to reference Zinbarg, R. E., Craske, M. G., & Barlow, D. H. (2006). Mastery of your anxiety and worry (2nd ed.). Oxford: Oxford University Press. Zinbarg, R. E., Craske, M. G., & Barlow, D. H. (2006). Mastery of your anxiety and worry (2nd ed.). Oxford: Oxford University Press.
Metagegevens
Titel
Experiential Avoidance as a Mechanism of Change Across Cognitive-Behavioral Therapy in a Sample of Participants with Heterogeneous Anxiety Disorders
Auteurs
Elizabeth H. Eustis
Nicole Cardona
Maya Nauphal
Shannon Sauer-Zavala
Anthony J. Rosellini
Todd J. Farchione
David H. Barlow
Publicatiedatum
21-11-2019
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 2/2020
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-019-10063-6

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