Avoidance and depression: the construction of the Cognitive–Behavioral Avoidance Scale

doi:10.1016/S0005-7967(03)00140-2

Behaviour Research and Therapy

Volume 42, Issue 3, March 2004, Pages 293-313

https://doi.org/10.1016/S0005-7967(03)00140-2 Get rights and content

Abstract

Previous research has demonstrated a relationship between avoidance and depression, although the nature of this relationship has been confused by inconsistent definitions of avoidance. Following a review of the construct of avoidance and an examination of past research, a new multidimensional measure of avoidance was developed and validated using an undergraduate student sample (245 females and 146 males). Four reliable factors reflecting combinations of cognitive/behavioral and social/nonsocial dimensions of avoidance were obtained from the factor analysis of the new scale, entitled the “Cognitive–Behavioral Avoidance Scale” (CBAS). The scale showed the predicted relationships with convergent and divergent measures used for construct validation. As predicted, subscales of the CBAS, as well as the overall scale score, were significantly related to the depression and anxiety criterion measures. The findings from this study suggest that avoidance may be an important construct in the psychosocial conceptualization of depression. In addition, this integrated measure of avoidance has potential utility for depression researchers. Suggestions for further scale development and research are provided.

Introduction

The construct of ‘avoidance’ refers to refraining from, or escaping from, an action, person or thing. Avoidance has been studied extensively in relation to anxiety and has been established as a central feature in the description, diagnosis and treatment of anxiety disorders (Barlow, 2002). In contrast, although Ferster (1973) postulated a central role for avoidance in his functional analysis of depression several decades ago, research examining avoidance in the context of depression has been comparatively scarce. Ferster’s model of depression stated that the depressed person engages in a high frequency of avoidance and escape from aversive internal and external stimuli with such behaviors as withdrawing or complaining, and that these efforts preempt positively reinforced behavior. Ferster indicated that the predominant employment of behaviors serving an avoidance or escape function leads to a narrowing of the depressed individual’s behavioral repertoire and that this repertoire becomes marked by passivity as opposed to initiative or action.

Despite this promising theoretical basis for empirical investigation, it has only been in recent years that researchers have begun to systematically examine the relationship between the construct of avoidance and depressive symptoms and disorders. It is possible that the construct of ‘avoidance’, as explored and clarified in this paper, is a permeating factor contributing to the established relationships between previously studied psychosocial variables and depression. The following review presents important research on avoidance in the context of depression and an integrated conceptualization of the avoidance construct which serves as the foundation for the construction of a multidimensional avoidance scale.

Section snippets

Literature review

In general, research examining the relationship between avoidance and depression has examined avoidance as: (1) a coping strategy, (2) a problem-solving style, and (3) a personality dimension. Positive associations between various definitions of avoidance subsumed under these facets and depression have been identified in a number of studies.

Participants

The sample consisted of 391 undergraduate students (245 females, 146 males) recruited through the University of Calgary, Department of Psychology Bonus Credit Program. The mean age of the participants was 21.70 years (SD=4.59; range 17–51). The racial makeup of the sample was predominantly Caucasian (62%), followed by Asian (28%), East Indian (6%), and other groups (4%).

Coping Responses Inventory (CRI; Moos, 1988)

The CRI is a self-report measure of eight different types of coping responses to stressful life situations as reflected in

Results

All ANOVAs conducted to test for questionnaire order effects on the new avoidance scale, depression and anxiety scores were nonsignificant. The section that follows describes the item reduction methods used to construct the new scale, and the final factor solution, reliability, convergent, divergent and criterion-related validity of the scale. The convergent, divergent and criterion-related analyses were conducted by gender and are reported as such. In addition, ancillary gender and racial

Discussion

The primary goal of this study was to develop and validate a multidimensional scale of avoidance. In line with hypotheses, it was found that cognitive versus behavioral and social versus nonsocial dimensions emerged in empirical analysis as important dimensions of avoidance. However, the hypothesized active versus passive dimension of avoidance did not emerge in this analysis. The final resulting factors/subscales, which included Behavioral Social, Cognitive Nonsocial, Cognitive Social and

Acknowledgements

This research was supported through grants awarded to N.D. Ottenbreit from the Alberta Heritage Foundation for Medical Research and the Alberta Heritage Scholarship Fund. The assistance of Ms. Catherine Munns with data collection and scoring is also gratefully acknowledged.

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Avoidance and depression: the construction of the Cognitive–Behavioral Avoidance Scale

Abstract

Introduction

Section snippets

Literature review

Participants

Coping Responses Inventory (CRI; Moos, 1988)

Results

Discussion

Acknowledgements

Personality and Individual Differences

Journal of Psychiatric Research

Behaviour Research and Therapy

European Psychiatry

Biological Psychiatry

Clinical Psychology Review

Anxiety and its disorders: The nature and treatment of anxiety and panic

Cognitive therapy of depression

Beck Depression Inventory—II manual

Depression and the ironic effects of thought suppression: therapeutic strategies for improving mental control

Clinical Psychology: Science and Practice

Ethnicity, coping, and distress among Korean Americans, Filipino Americans and Caucasian Americans

The Journal of Social Psychology

Interaction of cognitive avoidance coping and stress in predicting depression/anxiety

Cognitive Therapy and Research

Situational coping and coping dispositions in a stressful transaction

Journal of Personality and Social Psychology

Assessing coping strategies: a theoretically-based approach

Journal of Personality and Social Psychology

Scientific foundations of cognitive theory and therapy of depression

A systematic method for clinical description and classification of personality variants: a proposal

Archives of General Psychiatry

The Tridimensional Personality Questionnaire: US normative data

Psychological Reports

The Temperament and Character Inventory (TCI): A guide to its development and use

Self-reported distress: analog or ersatz depression?

Psychological Bulletin

Issues in personality as diathesis for depression: the case of sociotropy–dependency and autonomy–self-criticism

Psychological Bulletin

Culturally competent assessment practice in the United States

Journal of Personality Assessment

Social problem-solving deficits and hopelessness, depression, and suicidal risk in college students and psychiatric patients

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