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E-ISSN : 2733-4538
Most people prefer avoiding anxious feelings over experiencing them. However, the efforts to avoid anxious feelings result in paradoxical effects which are characterized by the amplifications of frequency, intensity and duration of anxiety. Therefore, clinical issues are not the experiences of anxiety per se but the efforts to avoid them. In this context, Bradley(2000) proposed that anxiety disorders reflect a combination of the experienced anxious feelings(i.e., experience component) and the efforts which an individual makes to deal with them(i.e., control component). What makes normal anxiety into pathological anxiety disorder is experiential avoidance, that is the dysfunctional attitude to psychological experiences. In present studies, the authors investigated the mediational effect of experiential avoidance in the relationships between harm avoidance and anxiety symptoms. Harm avoidance is the temperamental vulnerability to anxious feelings. In order to evaluate goodness-of-fit of the mediation model, two studies were conducted. In Study 1, cross-sectional data were collected from 328 undergraduate students and were analyzed by structural equation modeling method. The results of Study 1 revealed that experiential avoidance partially mediated the relationship between harm avoidance and anxiety symptoms. In Study 2, which was designed to examine whether the results of Study 1 could be cross-validated, short-term longitudinal data were collected from an independent sample and were analyzed by structural equation modeling methods. The results of Study 2 showed that experiential avoidance fully mediated the relationship between harm avoidance and anxiety symptoms. These findings suggest that temperamental vulnerability(i.e., harm avoidance) influences anxiety symptoms directly as well as indirectly, through mediation of the attitudinal vulnerability(i.e., experiential avoidance). Based on the findings, the authors discussed the implications of present studies in theoretical and clinical manner. Finally, the limitations of these studies were discussed along with suggestions for further research.
권석만, 유성진, 정지현 (2001). 걱정이 많은 사람의 인지적 특성: 위협평가와 위협대처에서의 인지적 편향과 파국적 사고경향. 한국심리학회지: 임상, 20(1), 467-487.
김정원, 민병배 (1998). 걱정과 불확실성에 대한 인내력 부족 및 문제해결방식과의 관계. 한국심리학회 연차학술발표대회논문집. 한국심리학회.
김 환, 이훈진 (2007). 경험적 회피와 회피적 반응의 관계: 행동적 회피, 감추기 및 거리두기를 중심으로. 한국심리학회지: 일반, 26(2), 225-243.
문현미 (2006). 심리적 수용 촉진 프로그램의 개발과 효과: 수용-전념 치료 모델을 중심으로. 가톨릭대학교 대학원 박사학위청구논문.
민병배, 오현숙, 이주영 (2007a). 기질 및 성격검사 매뉴얼. 서울: (주)마음사랑.
민병배, 오현숙, 이주영 (2007b). 기질 및 성격검사 성인용(TCI-RS). 서울: (주)마음사랑.
유성진 (2000). 걱정이 많은 사람들의 성격 및 인지적 특성: 위협에 대한 재평가가 걱정에 미치는 영향. 서울대학교 대학원 석사학위청구논문.
유성진, 권석만 (2009). 심리평가 및 심리치료에 있어서 기질-성격 모형의 임상적 시사점. 한국심리학회지: 임상, 28(2), 563-586.
이숙희, 황순택 (2009). 기질 및 성격검사 성인용(TCI-RS)의 구인타당도: 대학생들의 우울과 불안을 중심으로. 한국심리학회지: 임상, 28(2), 533-548.
이정은, 조용래 (2007). 걱정에 대한 부정적 신념과 일반화된 불안증상 간의 관계에서 경험적 회피의 매개효과. 한국심리학회지: 임상, 26(4), 939-961.
조용래 (2008). 걱정의 통제 불능성/위험에 대한 부정적 신념과 시험불안의 관계: 경험회피의 매개역할. 한국심리학회지: 임상, 27(4), 891-909.
Abramson, L. Y., Alloy, L. B., & Metalsky, G. I. (1988). The cognitive diathesis-stress theories of depression: Toward an adequate evaluation of the theories' validities. In L. B. Alloy (Eds.), Cognitive processes in depression (pp.3-30). NY: The Guilford Press.
Agras, S., Sylvester, D., & Oliveau, D. (1969). The epidemiology of common fears and phobias. Comprehensive Psychiatry, 10, 151-156.
Antony, M. M., Purdon, C. L., Huta, V., & Swinson, R. P. (1998). Dimensions of perfectionism across the anxiety disorders. Behaviour Research and Therapy, 36, 1143-1154.
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10(2), 125-142.
Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). NY: The Guilford Press.
Barlow, D. H., & Durand, V. M. (2004). Essentials of abnormal psychology (4th ed.). NY: Wadsworth.
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35(2), 205-230.
Battaglia, M., Przybeck, T. R., Bellodi, L., & Cloninger, C. R. (1996). Temperament dimensions explain the comorbidity of psychiatric disorders. Comprehensive Psychiatry, 37, 292-298.
Beck, A. T. (1996). Beyond belief: A theory of modes, personality, and psychopathology. In P. M. Salkovskis (Eds.), Frontiers of cognitive therapy (pp.1-25). NY: The Guilford Press.
Beck, A. T., Emery, G., & Greenberg, R. L. (1985). Anxiety disorders and phobias: A cognitive perspectives. NY: Basic Books.
Beck, A. T., Freeman, A., & Davis, D. D. (2004). Cognitive therapy of personality disorders. NY: The Guilford Press.
Beck, J. S. (1996). Cognitive therapy of personality disorders. In P. M. Salkovskis (Eds.), Frontiers of cognitive therapy (pp.165-181). NY: The Guilford Press.
Borkovec, T. D. (1994). The nature, functions, and origins of worry. In G. C. L. Davey & F. Tallis (Eds.), Worrying: Perspectives on theory, assessment and treatment (pp.29-50). England: Wiley.
Bradley, S. J. (2000). Affect regulation and the development of psychopathology. NY: The Guilford Press.
Breckler, S. J. (1990). Applications of covariance structure modeling in psychology. Psychological Bulletin, 107, 260-273.
Butler, G., & Mathews, A. (1987). Anticipatory anxiety and risk perception. Cognitive Therapy and Research, 11, 551-565.
Ciarrochi, J. V., & Bailey, A. (2008). A CBT practitioner's guide to ACT: How to bridge the gap between cognitive behavioral therapy and acceptance and commitment therapy. CA: New Harbinger Publications.
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461- 470.
Clark, D. M. (1996). Panic disorder: From theory to therapy. In P. M. Salkovskis (Eds.), Frontiers of cognitive therapy (pp.318-344). NY: The Guilford Press.
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp.69-93). NY: The Guilford Press.
Cloninger, C. R. (1987). A systematic method for clinical description and classification of personality variants: A proposal. Archives of General Psychiatry, 44, 573-587.
Cloninger, C. R. (2004). Feeling good: The science of well-being. NY: Oxford University Press.
Cloninger, C. R., & Svrakic, D. M. (2000). Personality disorders. In B. J. Sadock & V. A. Sadock (Eds.), Comprehensive textbook of psychiatry (pp.1723-1764). NY: Lippincott Williams & Wilkins.
Cloninger, C. R., Bayon, C., & Svrakic, D. M. (1998). Measurement of temperament and character in mood disorders: A model of fundamental states as personality types. Journal of Affective Disorders, 51, 21-32.
Cloninger, C. R., Przybeck, T. R., Svrakic, D. M., & Wetzel, R. D. (1994). The Temperament and Character Inventory(TCI): A guide to its development and use. St. Louis, Missouri.
Craske, M. G. (1991). Phobic fear and panic attacks: The same emotional states triggered by different cues? Clinical Psychology Review, 11, 599-620.
Craske, M. G. (1999). Anxiety disorders: Psychological approaches to theory and treatment. Boulder, CO: Westview Press.
Davey, G. C. L., & Levy, S. (1998). Catastrophic worrying: Personal inadequacy and a perseverate iterative styles as features of the catastrophising process. Journal of Abnormal Psychology, 107, 576-586.
Davey, G. C. L., Hampton, J., Farrell, J., & Davidson, S. (1992). Some characteristics of worrying: Evidence for worrying and anxiety as separate constructs. Personality and Individual Differences, 13(2), 133-147.
David, D., & Szentagotai, A. (2006). Cognitions in cognitive-behavioral psychotherapies: Toward an integrative model. Clinical Psychology Review, 26, 284-298.
Davidson, J. R. T., & Foa, E. B. (1991). Refining criteria for posttraumatic stress disorder. Hospital and Community Psychiatry, 42, 259-261.
Dugas, M. J., Freeston, M. H., & Ladouceur, R. (1997). Intolerance of uncertainty and problem orientation in worry. Cognitive Therapy and Research, 21, 593-606.
Eifert, G. H., & Forsyth, J. P. (2005). Acceptance and commitment therapy for anxiety disorders. CA: New Harbinger Publications.
Ellis, A. & MacLaren, C. (1995). Rational emotive behavior therapy: A therapist's guide. CA: Impact Publishers.
Feldner, M. T., Zvolensky, M., Eifer, G. H., & Spira, A. (2003). Emotional avoidance: An experimental test of individual differences and response suppression using biological challenge. Behaviour Research and Therapy, 41(4), 403- 411.
Foa, E. B., & Kozak, M. J. (1991). Emotional processing: Theory, research, and clinical implications for anxiety disorders. In J. D. Safran & L. S. Greenberg (Eds.), Emotion, psychotherapy, and change (pp.21-49). NY: The Guilford Press.
Forsyth, J. P., Parker, J., & Finlay, C. G. (2003). Anxiety sensitivity, controllability, and experiential avoidance and their relation to drug of choice and addiction severity in a residential sample of substance abusing veterans. Addictive Behaviors, 28, 851-870.
Friedman, A. F., Webb, J. T., & Lewak, R. (1989). Psychological assessment with MMPI. NJ: Lawrence Erlbaum Associates.
Frijda, N. H. (1986). The emotions. Cambridge: Cambridge University Press.
Fruzzetti, A. E., Shenk, C., Mosco, E., & Lowry, K. (2003). Emotion regulation. In W. O'Donohue, J. E. Fisher, & S. C. Hayes (Eds.), Cognitive behavior therapy: Applying empirically supported techniques in your practice (pp.152-159). NJ: John Wiley & Sons.
Gabbard, G. O. (2000). Psychodynamic psychiatry in clinical practice. Washington, DC: American Psychiatric Press.
Germer, C. K. (2005). Anxiety disorders: Befriending fear. In C. K. Germer, R. D. Siegel, & P. R. Fulton (Eds.), Mindfulness and psychotherapy (pp.152-172). NY: The Guilford Press.
Goldstein, A. J., & Chambless, D. L. (1978). A reanalysis of agoraphobia. Behavior Therapy, 9, 47-59.
Gray, J. A. (1982). The neuropsychology of anxiety. NY: Oxford University Press.
Greenberg, L. S., & Paivio, S. (1997). Working with emotions in psychotherapy. NY: The Guilford Press.
Greenberg, L. S., Rice, L. N., & Elliott, R. (1993). Facilitating emotional change: The moment-by- moment process. NY: The Guilford Press.
Hayes, S. C. (2004). Acceptance and commitment therapy and the new behavior therapies: Mindfulness, acceptance, and relationship. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition (pp.1- 29). NY: The Guilford Press.
Hayes, S. C. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. CA: New Harbinger Publications.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. NY: The Guilford Press.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., Polusny, M.. A., Dykstra, T. A., Batten, S. V., Bergan, J., Stewart, S. H., Zvolensky, M. J., Eifert, G. H., Bond, F. W., Forsyth, J. P., Karekla, M., & Mccurry, S. M. (2004). Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record, 54, 553-578.
Horowitz, M. J. (1986). Stress-response syndromes: A review of posttraumatic and adjustment disorders. Hospital and Community Psychiatry, 27, 267-271.
Hu, L. T., & Bentler, P. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55.
Kagan, J. (1989). Temperamental contributions to social behavior. American Psychologist, 44, 668- 674.
Kagan, J. (1997). Temperament and the reactions to unfamiliarity. Child Development, 68, 139- 143.
Karekla, M., Forsyth, J. P., & Kelly, M. M. (2004). Emotional avoidance and panicogenic responding to a biological challenge procedure. Behavior Therapy, 35, 725-746.
Kernberg, O. (1976). Object-relations theory and clinical psychoanalysis. NY: Jason Aronson.
Leahy, R. L. (2001). Overcoming resistance in cognitive therapy. NY: The Guilford Press.
Leahy, R. L. (2003). Emotional schemas and resistance. In R. L. Leahy (Eds.), Roadblocks in cognitive behavioral therapy: Transforming challenges into opportunities for change (pp.91-115). NY: The Guilford Press.
LeDoux, J. E. (1996). The emotional brain. NY: Simon & Schuster.
Linehan, M. M. (1993). Cognitive behavioral treatment of borderline personality disorder. NY: The Guilford Press.
Luoma, J. B., Hayes, S. C., & Walser, R. D. (2007). Learning ACT: An acceptance and commitment therapy skills-training manual for therapists. CA: New Harbinger Publications.
MacKinnon, R. A., & Michels, R. (1971). The psychiatric interview in clinical practice. Philadelphia: Saunders.
Malcarne, V. L., & Hansdottir, I. (2001). Vulnerability to anxiety disorders in childhood and adolescence. In R. E. Ingram & J. M. Price (Eds.), Vulnerability to psychopathology: Risk across the lifespan (pp.271-303). NT: The Guilford Press.
McWilliams, N. (1994). Psychoanalytic diagnosis: Understanding personality structure in the clinical process. NY: The Guilford Press.
Mowrer, O. H. (1950). Learning theory and personality dynamics. NY: Ronald.
Nardone, G., & Watzlawick, P. (1993). Clinical practice, processes, and procedures. In G. Nardone & P. Watzlawick (Eds.), The art of change (pp.45-72). San Francisco: Jossey-Bass.
Olendzki, A. (2005). The roots of mindfulness. In C. K. Germer, R. D. Siegel, & P. R. Fulton (Eds.), Mindfulness and psychotherapy (pp.241- 261). NY: The Guilford Press.
Peirson, A. R., & Heuchert, J. W. (2001). The relationship between personality and mood: Comparison of the BDI and the TCI. Personality and Individual Differences, 30, 391- 399.
Pretzer, J. L., & Beck, A. T. (1996). A cognitive theory of personality disorders. In J. F. Clarkin & M. F. Lenzenweger (Eds.), Major theories of personality disorders (pp.36-105). NY: The Guilford Press.
Purdon, C., & Clark, D. A. (1993). Obsessive intrusive thoughts in nonclinical subjects. Part I. Content and relation with depressive, anxious and obsesssional symptoms. Behaviour Research and Therapy, 31, 712-720.
Rachman, S. (1993). Obsessions, responsibility and guilt. Behaviour Research and Therapy, 31, 149- 154.
Rachman, S., & Shafran, R. (1998). Cognitive and behavioral features of obsessive compulsive disorder. In R. P. Swinson, M. M. Antony, S. Rachman, & M. A. Richter (Eds.), Obsessive- compulsive disorder: Theory, research, and treatment (pp.51-78). NY: The Guilford Press.
Richter, J., Polak, T., & Eisemann, M. (2003). Depressive mood and personality in terms of temperament and character among the normal population and depressive inpatients. Personality and Individual Differences, 35, 917-927.
Roemer, L., & Borkovec, T. D. (1994). Effects of suppressing thoughts about emotional material. Journal of Abnormal Psychology, 103, 467-474.
Roemer, L., & Orsillo, S. M. (2003). Mindfulness: A promising intervention strategy in need of further study. Clinical Psychology: Science and Practice, 10(2), 172-178.
Roemer, L., & Orsillo, S. M. (2009). Mindfulness- and acceptance-based behavioral therapies in practice. NY: The Guilford Press.
Safran, J. D., & Greenberg, L. S. (1991). Emotion in human functioning: Theory and therapeutic implications. In J. D. Safran & L. S. Greenberg (Eds.), Emotion, psychotherapy, and change (pp.3-18). NY: The Guilford Press.
Safran, J. D., & Segal, Z. V. (1990). Interpersonal process in cognitive therapy. NY: Basic Books.
Salkovskis, P. M. (1996). The cognitive approach to anxiety: Threat beliefs, safety-seeking behavior, and the special case of health anxiety and obsessions. In P. M. Salkovskis (Eds.), Frontiers of cognitive therapy (pp.48-74). NY: The Guilford Press.
Salkovskis, P. M., & Campbell, P. (1994). Thought suppression in naturally occurring negative intrusive thoughts. Behaviour Research and Therapy, 32, 1-8.
Scheier, M. F., & Carver, C. S. (1985). Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychology, 5, 219-247.
Shapiro, D. H., & Astin, J. A. (1998). Control therapy: An integrated approach to psychotherapy, health, and healing. NY: John Wiley & Sons.
Siegel, R. D. (2005). Psychophysiological disorders: Embracing pain. In C. K. Germer, R. D. Siegel, & P. R. Fulton (Eds.), Mindfulness and psychotherapy (pp.173-196). NY: The Guilford Press.
Sloan, D. M. (2004). Emotion regulation in action: Emotional reactivity in experiential avoidance. Behaviour Research and Therapy, 42, 1257-1270.
Strosahl, K. D., Hayes, S. C., Wilson, K. G., & Gifford, E. V. (2004). An ACT primer: Core therapy processes, intervention strategies, and therapist competencies. In S. C. Hayes & K. D. Strosahl (Eds.), A practical guide to acceptance and commitment therapy (pp.31-58). NY: Springer.
Waelder, R. (1960). Basic theory of psychoanalysis. NY: International Universities Press.
Wegner, D. M. (1994). Ironic processes of mental control. Psychological Review, 101, 34-52.
Wells, A. (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. NJ: John Wiley.
Wells, A. (2004). A short form of the meta- cognitions questionnaire: Properties of the MCQ-30. Behaviour Research and Therapy, 42, 385-396.
Wells, A., & Carter, K. (1999). Preliminary tests of a cognitive model of generalized anxiety disorder. Behaviour Research and Therapy, 37, 585-594.
Zettle, R. D. (2003). Acceptance and commitment therapy vs. systematic desensitization in treatment of mathematics anxiety. The Psychological Record, 53, 197-215.
Zvolensky, M. J., & Forsyth, J. P. (2002). Anxiety sensitivity dimensions in the prediction of body vigilance and attentional-based coping strategies. Cognitive Therapy and Research, 26, 449-460.