The transdiagnostic model of worry: The mediating role of experiential avoidance
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An inability to be psychologically flexible (experiential avoidance) can lead to increased sensitivity to aversive experiences and has been linked to undesirable psychological effects such as delusional beliefs.
“In contrast, an inability to be psychologically flexible (experiential avoidance) can lead to increased sensitivity to aversive experiences and has been linked to various undesirable psychological effects, such as delusional beliefs (11, 13).”
Indirect evidence suggests that fears of negative evaluation, physical sensations, or uncertainty may predict EA in the context of other disorders, such as symptoms of eating disorders and generalized anxiety disorder.
“However, indirect evidence suggests that each may predict EA in the context of the other disorders, such as symptoms of eating disorders (Espel-Huynh et al., 2019) and generalized anxiety disorder (Akbari & Khanipour, 2018).”
From Evaluating Mechanisms: Mapping Weekly Dynamics between Experiential Avoidance and SAD Symptoms (2021) · cites this paper as Akbari & Khanipour, 2018
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“Experiential avoidance can be viewed as a self-regulation strategy which may link various risk factors across mental health problems including worry (Akbari & Khanipour, 2018; Fischer et al., 2016) and on the other hand psychological flexibility may help in recovering form negative emotions…”
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“Recent studies have suggested that experiential avoidance may be strongly linked to internalized coping processes like rumination (Giorgio et al., 2010; Thomas, Raynor, & Ribott, 2015) and worry (Akbari & Khanipour, 2018; Buhr & Dugas, 2012).”
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“Similarly, worry has been identified as a transdiagnostic construct common to depressive symptoms, anxiety [81, 82] and pain [3] possibly serving a psychological function to reduce negative affect associated with underlying interpretational thought-memory-interactions [83].”
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“For example, among 557 students in Iran, measures of metacognitions, IU, emotional schema, and acceptance collectively accounted for 74% in worry scores; the zero-order correlations between the predictors varied from .21 to .64 (Akbari and Khanipour, 2018).”
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“In contrast, an inability to be psychologically fl exible (experiential avoidance) can lead to increased sensitivity to aversive experiences and has been linked to various undesirable psychological effects, such as delusional beliefs (11, 13).”
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“In this transdiagnostic model, experiential avoidance links the effects of intolerance of uncertainty, metacognitions, and emotional schemas on excessive worry (Akbari & Khanipour, 2018).”
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“In this population, EA has been linked to different risk factors and mental disorders [13] and could be a potential predictor of depressive and anxiety symptoms [14].”
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“It has been argued that modifying these cognitive processes through a transdiagnostic psychological treatment could help to reduce the severity of the different EDs symptoms at the same time (Akbari & Khanipour, 2018; Aldao et al., 2010; Salguero et al., 2019).”
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“A link between perseverative thinking and avoidance can be expected because rumination is related with avoidant emotion regulation strategies (Aldao et al., 2010) and discussed in the affect intolerance and experiential avoidance framework (Akbari & Khanipour, 2018).”
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Evaluating Mechanisms: Mapping Weekly Dynamics between Experiential Avoidance and SAD Symptoms
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“Experiential avoidance was found to be associated with worrying (Akbari & Khanipour, 2018; Yıldırım & Bahtiyar, 2022) and rumination (Giorgio et al., 2010; Thomas et al., 2015).”
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“However, the lack of a short-form of a valid measure to research in psychopathology and effectiveness of treatments has been a limitation (Akbari & Khanipour, 2018) metacognitive model, model of emotional schemas and acceptance-based model.”
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Moroń, M., & Krok, D. (2025) · Family Forum · doi:10.25167/ff/5630
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“It also supports the acceptance of internal experience as the theoretical basis for psychotherapy for generalized anxiety disorder (Akbari and Khanipour 2018).”
The tokophobia severity scale: a psychometric multicountry study with childbearing-age women
Fidalgo, D., Sousa, M. D., Sousa, C., Jomeen, J., Pawlicka, P., Riklikienė, O., Lamela, D. J. P. D. V., Baird, K., Baranowska, B., Jarašiūnaitė–Fedosejeva, G., et al. (2026) · Archives of Women s Mental Health · doi:10.1007/s00737-026-01736-9
“Given the TSS focus on worry - a transdiagnostic features of many mental health disorders (Akbari et al. 2018 ) - it has also the potential to predict further mental health problems in the postpartum period.”
Well-being comparisons and mental health outcomes following loss: a two-wave longitudinal study
Schlechter, P., Hoppen, T. H., Bonanno, G. A., & Nexhmedin Morina, B. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2026.2686574
“There is evidence that worry (Akbari & Khanipour, 2018; McEvoy et al., 2013), rumination (Bernstein et al., 2019; Ehring, 2021), avoidance (Eisma & Stroebe, 2017), and childhood adversity (Chen et al., 2020; McLaughlin et al., 2012) represent important risk factors in the context of mental health…”
Vieira, J. L., Antony, M. M., Milligan, K., Tabri, N., & Kim, H. S. A. (2026) · Journal of Behavioral Addictions · doi:10.1556/2006.2026.00064
- Authors
- Akbari, M., & Khanipour, H.
- Affiliations
- Kharazmi University (IR)
- Corresponding author
- Akbari, Mehdi
- Venue
- Personality and Individual Differences
- Publisher
- Elsevier BV
- Published
- 2018-12
- Volume
- 135
- Pages
- 166-172
- ISSN
- 0191-8869 (ISSN-L)
- OpenAlex
- W2883143471
- Cited by
- 30
- References
- 67
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 8 · 2023: 2 · 2022: 4 · 2021: 5 · 2019: 2
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Personality and Individual Differences (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- pathological worry, transdiagnostic model, experiential avoidance, intolerance of uncertainty, metacognitive beliefs, emotional schemas, acceptance and commitment therapy, generalized anxiety disorder, non-clinical population
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