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Cited by 12Mindfulness and Compassion InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychosomatic Disorders and Their Treatments

Mindful attention moderating the effect of experiential avoidance in terms of mental health among Latinos in a federally qualified health center

Open access
Raines, Elizabeth M., Rogers, Andrew H., Bakhshaie, Jafar, Viana, Andres G., Lemaire, Chad, Garza, Monica, Mayorga, Nubia A., Ochoa-Perez, Melissa +1 more·2018·Psychiatry Research
DOI 10.1016/j.psychres.2018.10.036PMC PMC12834457
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Abstract

The present study examined the moderating role of mindful attention in the relation between experiential avoidance and anxious arousal, social anxiety, depressive symptoms, and the number of mood and anxiety disorders among a sample of Latinos seeking health services at a primary care facility. Participants included 326 adult Latinos (M age = 39.79 years, SD = 11.27; 88.9% female; 98.2% used Spanish as their first language). Results provided empirical evidence of an interaction between mindful attention and experiential avoidance for anxious arousal, social anxiety, depressive symptoms, and the number of mood and anxiety disorders in the studied sample. Specifically, among Latinos with lower (vs higher) levels of mindfulness, greater experiential avoidance was related to greater anxiety/depressive symptoms and number of mood and anxiety disorders. Together, these data provide novel empirical evidence of the clinically relevant interplay between mindful attention and experiential avoidance regarding a relatively wide array of negative emotional symptoms and disorders among Latino primary care patients. Limitations of the study include a largely female sample and cross-sectional data. © 2018

Integrity signals

Registry

Crossref · 10.1016/j.psychres.2018.10.036

Cites

46 of 46 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

2 of 18 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured

  • Findingown data

    In the sample, experiential avoidance was significantly positively associated with the number of mood and anxiety disorders in adjusted models.

    “AAQ total score was significantly positively associated with the number of mood and anxiety disorders (B = 0.05, SE = 0.01, p < 0.001, sr2= 0.18)”
    Quote in the paperSubstantial claim
  • Findingown data

    In the sample of 326 adult Latinos in primary care, experiential avoidance was significantly positively associated with depressive symptoms in adjusted models.

    “AAQ total score was significantly positively associated with IDAS depression scores (B = 0.81, SE = 0.06, p < 0.001, sr2= 0.30)”
    Quote in the paperSubstantial claim
  • Findingown data

    In the sample, experiential avoidance was significantly positively associated with social anxiety symptoms in adjusted models.

    “AAQ total score was significantly positively associated with IDAS social anxiety scores (B = 0.18, SE = 0.02, p < 0.001, sr2= 0.22)”
    Quote in the paperSubstantial claim
  • Findingown data

    Approximately 38% of the sample met criteria for a current axis I disorder.

    “approximately 38% of the sample met criteria for a current axis I disorder.”
    Quote in the paperNot a substantial claim
  • Interpretationown data

    Mindful attention may act as a protective factor against greater anxiety/depressive symptoms and disorders in the context of higher experiential avoidance among Latinos in primary care.

    “the results from the current investigation generally suggest that mindful attention may act as a possible protective factor against experiencing greater anxiety/depressive symptoms and disorders in the face of (higher) experiential avoidance.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 12
  • May combine two claims. 8
  • The quote only partly states this claim. 2

  • Classified as probably not a substantial claim.

    Premisecitation

    Greater mindful attention may buffer the adverse effects of rumination on PTSD symptoms among trauma-exposed Latinos.

    “one study found that greater levels of mindful attention may buffer the adverse effects of greater levels of rumination on posttraumatic stress symptoms among trauma-exposed Latinos (Viana et al., 2017)”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Viana et al., 2017 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Mindful attention is negatively related to the intensity and frequency of negative affect symptoms among largely Caucasian samples.

    “among largely Caucasian samples, mindful attention is negatively related to the intensity and frequency of negative affect symptoms”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Brown and Ryan, 2003 source
    • cites Carlson and Brown, 2005 source
    • cites Gonzalez et al., 2009 source

      The Results report that mindful attention was negatively correlated with anxiety and depressive symptoms, and Method > Participants describes the HIV/AIDS sample as 85.7% Caucasian (pages not provided). Method > Measures assesses symptom severity, not the frequency of negative-affect symptoms. The paper therefore supports the association in one largely Caucasian sample, but not the claim about symptom frequency or multiple samples. (LLM, conf=0.85)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    There was a significant interaction between experiential avoidance and mindful attention predicting depressive symptoms, with a weaker positive association between experiential avoidance and depressive symptoms among those with high mindful attention compared to those with low mindful attention.

    “Inclusion of the interaction term in step 3 of the model yielded a significant increase in the variance accounted for in IDAS depression (ΔR2 = 0.01, p = 0.02). Specifically, results suggest that, among those with high (but not low) MAAS scores, higher AAQ scores were associated with lower depression scores (B = 0.62, SE = 0.11, p < 0.001) than those with low MAAS scores (B = 0.91, SE = 0.08, p <”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    In the sample, experiential avoidance was significantly positively associated with anxious arousal symptoms in adjusted models.

    “AAQ total score was significantly positively associated with IDAS social anxiety scores (B = 0.26, SE = 0.03, p < 0.001, sr2= 0.15)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There was a significant interaction between experiential avoidance and mindful attention predicting anxious arousal symptoms, such that experiential avoidance was not associated with anxious arousal among those with high mindful attention but was associated with elevated anxious arousal among those with low mindful attention.

    “Entering the interaction term in step 3 of the model yielded a significant increase in the variance accounted for in IDAS anxious arousal score (ΔR2 = 0.02, p = 0.001). Specifically, among those with high MAAS scores, higher AAQ scores were not associated with anxious arousal scores (B = 0.10, SE = 0.06, p = 0.06), whereas among those with low MAAS scores, AAQ scores were associated with elevated”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There was a significant interaction between experiential avoidance and mindful attention predicting social anxiety symptoms, with a weaker positive association at high mindful attention.

    “Including the interaction term in step 3 of the model yielded a significant increase in the variance accounted for in IDAS social anxiety score (ΔR2 = 0.03, p < 0.001). Specifically, among those with high (but not low) MAAS scores, higher AAQ scores were associated with lower social anxiety scores (B = 0.08, SE = 0.03, p < 0.006) than those with low MAAS scores (B = 0.23, SE = 0.02, p < 0.001”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Experiential avoidance and mindful attention were negatively correlated in the sample, sharing 12% of variance.

    “AAQ total score and MAAS total score also were negatively correlated with one another (r = −0.35, p < 0.01; 12% shared variance).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    There was a significant interaction between experiential avoidance and mindful attention predicting the number of mood and anxiety disorders, with a weaker positive association at high mindful attention.

    “Including the interaction term in step 3 of the model yielded a significant increase in the variance accounted for in predicting the number of mood and anxiety disorders (ΔR2 = 0.02, p = 0.002). Specifically, among those with high (but not low) MAAS scores, higher AAQ scores were associated with fewer mood and anxiety disorders (B = 0.02, SE = 0.01, p = 0.001) than those with low MAAS scores (B =”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    Mindful attention did not have a significant main effect on any of the four mental health outcomes (depressive symptoms, social anxiety, anxious arousal, number of mood and anxiety disorders) in adjusted models.

    “experiential avoidance exhibited a positive main effect on all four of the dependent variables, whereas mindful attention did not have a main effect on any of such variables.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Greater mindful attention moderated the negative impact of lesser subjective social status on anxiety/depressive symptoms among Latinos in primary care.

    “another investigation found that greater mindful attention moderated the negative impact of lesser levels of subjective social status among Latinos in primary care in regard to anxiety/depressive symptoms (Zvolensky et al., 2017).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Zvolensky et al., 2017 source

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). May combine two claims.

    Study design and conductcitation

    The study used Spanish-language versions of the AAQ, MAAS, and IDAS.

    “The current study employed the use of the Spanish version of this questionnaire (Ruiz et al., 2013).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Diagnostic assessments were performed using the MINI by trained Spanish-speaking staff under supervision of an independent doctoral-level rater.

    “Interviews were administered by trained, Spanish-speaking staff, under the supervision of an independent doctoral-level rater.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Experiential avoidance is a transdiagnostic construct implicated in a variety of psychiatric problems.

    “Experiential avoidance is theorized to be a broad-based affective diathesis that is implicated in a variety of psychiatric problems”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Blackledge and Hayes, 2001 source
    • cites Hayes et al., 1996 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The AAQ showed good internal consistency in the current study (Cronbach's α = 0.82).

    “showed good internal consistency in the current study (Cronbach’s α = 0.82).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The IDAS subscales used (general depression, anxious arousal, social anxiety) showed internal consistency in the current study (α = 0.90, 0.90, 0.77).

    “In the current study, the general depression (Cronbach’s α = 0.90), anxious arousal (Cronbach’s α = 0.90), and social anxiety (Cronbach’s α = 0.77) subscales were used”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationown data

    The present findings may be more representative of women than men in the Latino population.

    “It may be that the present findings are more representative of women than men in the Latino population.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Latinos are less likely to utilize mental health services and less likely to receive adequate care.

    “available data suggest Latinos are less likely to utilize mental health services and those who do seek treatment are less likely to receive adequate care (Alegria et al., 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Alegria et al., 2008 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Approximately 12% of randomly selected MINI interviews were checked for accuracy, with no cases of diagnostic disagreement.

    “Approximately 12% of randomly selected interviews were checked for accuracy, with no cases of diagnostic disagreement noted.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The analyses adjusted for employment status, marital status, age, gender, years of education, and years in the US as covariates.

    “step 1 included the following covariates: employment status, marital status, age, gender, years of education, and years in the US”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The MAAS showed strong internal consistency in the current study (Cronbach's α = 0.95).

    “showed strong internal consistency in the current study (Cronbach’s α = 0.95).”
    Quote in the paperNot a substantial claim
20 of 20

  • The paper relies on this without support.

    Little research has examined risk factors for the emergence, persistence, and maintenance of anxiety and depressive disorders among Latinos in clinical settings.

    “Yet, there has been little research focused on understanding risk factors for the expression, development, and maintenance of anxiety and depressive disorders among the Latino population in clinical settings.”

  • The paper relies on this without support.

    Empirical knowledge is very limited regarding anxiety/depressive symptoms and disorders among Latinos and the individual difference factors that may govern affective vulnerability.

    “Yet, there is highly limited empirical knowledge pertaining to the expression of anxiety/depressive symptoms and disorders among the Latino population and the individual difference factors that may govern affective vulnerability.”

  • The paper relies on this without support.

    No prior work has tested this moderation model among Latinos or in general for anxiety/depressive symptoms.

    “To date, no work has explored this type of moderation model among Latinos (or, in general) in terms of the experience of anxiety/depressive symptoms”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Low distress tolerance, measured by anxiety sensitivity, moderates the benefits of mindfulness interventions and appears to reduce their success in coping with negative affect and substance cravings.

    “Specifically, low DT (assessed by anxiety sensitivity) has been found to moderate the benefits of mindfulness interventions, appearing to impair the success of mindfulness strategies for coping with negative affect (anxiety) and substance cravings (Arch & Ayers, 2013; Rogojanski, Vettese, & Antony, 2011; see also Raines et al., 2018; Zvolensky et al., 2015).”

    From A randomized controlled trial protocol for engaging distress tolerance and working memory to aid smoking cessation in low socioeconomic status (SES) adults (2020) · cites this paper as Raines et al., 2018

    The Discussion reports an interaction between mindful attention and experiential avoidance in relation to anxiety and depressive symptoms among Latino primary-care patients. It does not show that low distress tolerance, assessed by anxiety sensitivity, moderates mindfulness-intervention benefits, nor does it assess substance cravings. The authors describe their data as cross-sectional and call for future intervention research. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • In non-COVID-19 research, experiential avoidance has been associated with negative mental health among Latinx populations.

    “In non-COVID-19 related work, EA has been related to negative mental health for the Latinx population (Raines et al., 2018; Zvolensky et al., 2015).”

    From Evaluating Experiential Avoidance in terms of COVID-19 Fear and Pandemic Emotional Distress Symptoms Among Latinx Adults (2022) · cites this paper as Raines et al., 2018

  • Experiential avoidance is associated with greater anxiety and depression among Hispanic individuals specifically.

    “For instance, experiential avoidance is related to greater anxiety and depression among racialized and ethnic minorities in general (Zvolensky et al., 2016) as well as among Hispanic individuals specifically (Bakhshaie et al., 2017; Raines et al., 2018).”

    From Perceived Discrimination, Experiential Avoidance, and Mental Health among Hispanic Adults in Primary Care (2022) · cites this paper as Raines et al., 2018

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Discussion reverses the direction of the interaction for experiential avoidance

    Major

    The Results section says that at higher mindfulness, greater experiential avoidance was related to less severe symptoms/disorders. In the Discussion, the same finding is described as experiential avoidance affecting symptoms only among those with lower mindful attention, which is the reverse framing of the moderation statement.

  • Protective-effect conclusion reverses the reported high-mindfulness slopes

    Major

    The discussion says greater experiential avoidance was related to less severe outcomes at higher mindful attention. The reported depression slope for that group is positive, meaning greater avoidance was associated with higher-not lower-depression scores; the reported social-anxiety and disorder-count slopes are positive as well.

  • Discussion overstates the range of variance added by main effects

    Minor

    The discussion gives 25%-38% as the range of additional variance explained by the main effects, but the anxious-arousal analysis reports 18%. The disorder-count analysis also reports a value below that range, at 22%.

  • Disorder-count analysis names social anxiety as its step-two outcome

    Minor

    The paragraph says the model predicts the number of mood and anxiety disorders, but its step-two variance statement identifies social anxiety score as the outcome.

  • Bivariate-effect interpretation conflicts with the reported correlations

    Minor

    The discussion suggests mindful attention lacked a direct bivariate effect, whereas the results explicitly report significant bivariate correlations between mindful attention and all three symptom measures. A nonsignificant adjusted main effect does not negate those reported bivariate associations.

  • Anxious-arousal analysis names the wrong outcome

    Minor

    Within the anxious-arousal regression results, the AAQ coefficient is described as an association with social anxiety scores instead of anxious-arousal scores.

6 of 6

Cites

Flagged first, then by citations

5 of the 51 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Alegría, 2008, Disparity in depression treatment among racial and ethnic minority populations in the United States, Psychiatr. Serv., 59, 1264, 10.1176/ps.2008.59.11.1264 · DOI · Paper page
  2. Hayes, 2004, Measuring experiential avoidance: a preliminary test of a working model, Psychol. Rec., 54, 553, 10.1007/BF03395492 · DOI · Paper page

Cited by

Sorted by citations

Related

Authors
Raines, E. M., Rogers, A. H., Bakhshaie, J., Viana, A. G., Lemaire, C., Garza, M., Mayorga, N. A., Ochoa-Perez, M., & Zvolensky, M. J.
Affiliations
  • University of Houston (US)
  • Legacy Community Health Services (US)
  • The University of Texas MD Anderson Cancer Center (US)
Corresponding author
Zvolensky, Michael J.
ORCID
Venue
Psychiatry Research
Publisher
Elsevier BV
Published
2018-12
Volume
270
Pages
574-580
ISSN
0165-1781 (ISSN-L)
DOI
10.1016/j.psychres.2018.10.036
PMC
PMC12834457
OpenAlex
W2896411922
Cited by
11
References
51
Citations by year
2025: 1 · 2022: 5 · 2021: 2 · 2020: 3
FWCI
1.47
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Psychiatry Research (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion)
Funders
  • National Institute of Mental Health (R01MH076629)
  • National Center for Complementary and Integrative Health (K23AT012364)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
mindful attention, mindfulness, experiential avoidance, anxious arousal, social anxiety, depressive symptoms, mood and anxiety disorders, Hispanic Americans, federally qualified health centers, primary care patients, mental health, moderated mediation
MeSH terms
Adult, Anxiety, Anxiety Disorders, Attention, Avoidance Learning, Cross-Sectional Studies, Depression, Depressive Disorder, Female, Hispanic or Latino, Humans, Male, Middle Aged, Primary Health Care, Southwestern United States, Mindfulness

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