Distress and avoidance in generalized anxiety disorder: Exploring the relationships with intolerance of uncertainty and worry

Lee, Jonathan K.; Orsillo, Susan M.; Roemer, Lizabeth; Allen, Laura B.

doi:10.1080/16506070902966918

Cited by 124Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMindfulness and Compassion InterventionsPsychotherapy Techniques and Applications

Distress and avoidance in generalized anxiety disorder: Exploring the relationships with intolerance of uncertainty and worry

Open access

Lee, Jonathan K., Orsillo, Susan M., Roemer, Lizabeth, Allen, Laura B.·2010·Cognitive Behaviour Therapy

DOI 10.1080/16506070902966918PMC PMC2866754

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Abstract

Theory and research suggest that treatments targeting experiential avoidance may enhance outcomes for patients with generalized anxiety disorder (GAD). The present study examined the role of experiential avoidance and distress about emotions in a treatment-seeking sample with a principal diagnosis of GAD compared with demographically matched nonanxious controls and sought to explore their shared relationship with two putative psychopathological processes in GAD: intolerance of uncertainty and worry. Patients with GAD reported significantly higher levels of experiential avoidance and distress about emotions compared with nonclinical controls while controlling for depressive symptoms, and measures of these constructs significantly predicted GAD status. Additionally, experiential avoidance and distress about anxious, positive, and angry emotions shared unique variance with intolerance of uncertainty when negative affect was partialed out, whereas only experiential avoidance and distress about anxious emotions shared unique variance with worry. Discussion focuses on implications for treatment as well as future directions for research. © 2010 Taylor & Francis.

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Crossref · 10.1080/16506070902966918

Cites

49 of 49 references verified0 citation errors · 0 not checkable

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Claims the paper makes

2 of 32 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured

Premisecitation
It is likely that experiential avoidance is a common factor in the presentation of general psychopathology.
“Given theory and research with a wide range of disorders (see Hayes et al., 2006, for a meta-analytic review), it is likely that experiential avoidance is a common factor in the presentation of general psychopathology.”
Quote in the paperNot a substantial claim1 of 1 sources checked
- cites Hayes et al., 2006 source
  The ACT/RFT theory section (pp. 6–7) presents experiential avoidance as part of a general model of psychopathology, and Research on ACT (pp. 12–13) reports meta-analyses spanning several psychological problems. However, Research on ACT (p. 10) cautions that the questionnaire used in those analyses measures several ACT processes, not experiential avoidance alone. The meta-analytic evidence therefore does not isolate experiential avoidance as the common factor claimed. (LLM, conf=0.84)
  Experimental — accuracy not yet measured
Premisecitation
Intolerance of uncertainty contributes to GAD severity even after controlling for age, gender, and depression.
“and GAD severity even after controlling for age, gender and depression (Dugas et al., 2007).”
Quote in the paperSubstantial claim1 of 1 sources checked
- cites Dugas et al., 2007 source
Findingown data
Measures of experiential avoidance and distress about emotions significantly predicted GAD status.
“measures of these constructs significantly predicted GAD status.”
- Also stated in: § Abstract · plain
  “measures of these constructs significantly predicted GAD status”
- Also stated in: § GAD versus Non-GAD Comparisons on Experiential Avoidance, and Distress about Emotions · hedged
  “indicating that the combination of predictors significantly discriminated between individuals with and without GAD”
Quote in the paperSubstantial claim
- Rests on an assumption: The AAQ measures experiential avoidance distinctly from general negative affectivity.
Findingown data
In the GAD group, distress about anxious emotions correlated significantly with intolerance of uncertainty when controlling for depression.
“However, the correlations between experiential avoidance and distress about anxious, positive, and angry emotions and intolerance of uncertainty remained significant, even while controlling for depression (and for the ACS-ANG subscale, gender), while distress about depressive emotions was not significant.”
Quote in the paperSubstantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
In the GAD group, distress about angry emotions did not remain significantly correlated with worry when controlling for self-reported depression.
“The correlations between experiential avoidance, distress about anxiety, and worry were significant when controlling for self-reported depression while distress about depressive, positive, and angry emotions did not remain significant”
Quote in the paperNot a substantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.

Findingown data
In the GAD group, distress about depressive emotions did not remain significantly correlated with intolerance of uncertainty when controlling for depression.
“However, the correlations between experiential avoidance and distress about anxious, positive, and angry emotions and intolerance of uncertainty remained significant, even while controlling for depression (and for the ACS-ANG subscale, gender), while distress about depressive emotions was not significant.”
Quote in the paperNot a substantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
In the GAD group, distress about positive emotions correlated significantly with intolerance of uncertainty when controlling for depression.
“However, the correlations between experiential avoidance and distress about anxious, positive, and angry emotions and intolerance of uncertainty remained significant, even while controlling for depression (and for the ACS-ANG subscale, gender), while distress about depressive emotions was not significant.”
Quote in the paperNot a substantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
Across the entire sample, intolerance of uncertainty, worry, and depression were significantly correlated with measures of experiential avoidance and distress about emotions.
“As expected, intolerance of uncertainty, worry, and depression, were significantly correlated with the measures of experiential avoidance and distress about emotions.”
Quote in the paperSubstantial claim
Findingown data
In the GAD group, experiential avoidance correlated significantly with intolerance of uncertainty when controlling for depression.
“However, the correlations between experiential avoidance and distress about anxious, positive, and angry emotions and intolerance of uncertainty remained significant, even while controlling for depression (and for the ACS-ANG subscale, gender), while distress about depressive emotions was not significant.”
Quote in the paperSubstantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
In the GAD group, distress about angry emotions correlated significantly with intolerance of uncertainty when controlling for depression and gender.
“However, the correlations between experiential avoidance and distress about anxious, positive, and angry emotions and intolerance of uncertainty remained significant, even while controlling for depression (and for the ACS-ANG subscale, gender), while distress about depressive emotions was not significant.”
Quote in the paperNot a substantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
In the GAD group, experiential avoidance correlated significantly with worry when controlling for self-reported depression.
“The correlations between experiential avoidance, distress about anxiety, and worry were significant when controlling for self-reported depression while distress about depressive, positive, and angry emotions did not remain significant”
Quote in the paperSubstantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
In the GAD group, distress about positive emotions did not remain significantly correlated with worry when controlling for self-reported depression.
“The correlations between experiential avoidance, distress about anxiety, and worry were significant when controlling for self-reported depression while distress about depressive, positive, and angry emotions did not remain significant”
Quote in the paperNot a substantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
The GAD group reported greater distress about depressive emotions than non-anxious controls after controlling for self-reported depression.
“individuals with GAD reported higher rates of experiential avoidance (η2p = .51) and greater distress about anxious (η2p = .61), depressive (η2p = .25), angry (η2p = .17), and positive (η2p = .11) emotions.”
Quote in the paperSubstantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
In the discriminant function analysis, GAD status accounted for 90% of the function variance.
“with GAD status accounting for 90% of the function variance”
Quote in the paperNot a substantial claim
- Rests on an assumption: The AAQ measures experiential avoidance distinctly from general negative affectivity.
Findingown data
There was a significant main effect of group on the combination of AAQ and ACS subscales after controlling for self-reported depression.
“As predicted, there was a significant main effect of group [F(5,58) = 22.80, p < .0005; Pillai's Trace = .66; η2p = .66].”
Quote in the paperSubstantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
- Rests on an assumption: The AAQ measures experiential avoidance distinctly from general negative affectivity.
Findingown data
The GAD group reported greater distress about anxious emotions than non-anxious controls after controlling for self-reported depression.
“individuals with GAD reported higher rates of experiential avoidance (η2p = .51) and greater distress about anxious (η2p = .61), depressive (η2p = .25), angry (η2p = .17), and positive (η2p = .11) emotions.”
Quote in the paperSubstantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
The GAD group reported greater distress about emotions overall than non-anxious controls after controlling for self-reported depression.
“Patients with GAD reported significantly higher levels of experiential avoidance and distress about emotions compared to non-clinical controls while controlling for depressive symptoms”
Quote in the paperSubstantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
Within the GAD group, men reported greater distress about anger than women on the ACS-ANG subscale.
“The only significant finding was that within the GAD group only, men reported greater distress about anger than women on the ACS-ANG subscale.”
Quote in the paperNot a substantial claim
Findingown data
In a treatment-seeking sample with principal GAD, the GAD group reported higher experiential avoidance than demographically matched non-anxious controls after controlling for self-reported depression.
“Patients with GAD reported significantly higher levels of experiential avoidance and distress about emotions compared to non-clinical controls while controlling for depressive symptoms”
- Also stated in: § GAD versus Non-GAD Comparisons on Experiential Avoidance, and Distress about Emotions · plain
  “individuals with GAD reported higher rates of experiential avoidance (η2p = .51)”
Quote in the paperSubstantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
In the GAD group, distress about anxiety correlated significantly with worry when controlling for self-reported depression.
“The correlations between experiential avoidance, distress about anxiety, and worry were significant when controlling for self-reported depression while distress about depressive, positive, and angry emotions did not remain significant”
Quote in the paperSubstantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
In the GAD group, distress about depressive emotions did not remain significantly correlated with worry when controlling for self-reported depression.
“The correlations between experiential avoidance, distress about anxiety, and worry were significant when controlling for self-reported depression while distress about depressive, positive, and angry emotions did not remain significant”
Quote in the paperSubstantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
The GAD group reported greater distress about positive emotions than non-anxious controls after controlling for self-reported depression.
“individuals with GAD reported higher rates of experiential avoidance (η2p = .51) and greater distress about anxious (η2p = .61), depressive (η2p = .25), angry (η2p = .17), and positive (η2p = .11) emotions.”
Quote in the paperNot a substantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
The GAD group reported greater distress about angry emotions than non-anxious controls after controlling for self-reported depression.
“individuals with GAD reported higher rates of experiential avoidance (η2p = .51) and greater distress about anxious (η2p = .61), depressive (η2p = .25), angry (η2p = .17), and positive (η2p = .11) emotions.”
Quote in the paperNot a substantial claim
- Rests on an assumption: The depression subscale of the DASS-21 adequately controls for negative affect.
Findingown data
ACS-ANX, AAQ, and ACS-DEP had the strongest relationship to GAD status, with correlations above .5.
“ACS-ANX (r = .85), AAQ (r = .80), and ACS-DEP (r = .52) demonstrated the strongest relationship (determined by r's > .5) to GAD status.”
Quote in the paperSubstantial claim
- Rests on an assumption: The AAQ measures experiential avoidance distinctly from general negative affectivity.
Premisecitation
Self-report of using worry to distract from more distressing topics distinguishes GAD from sub-clinical cases.
“self-report of the use of worry to distract from more distressing topics distinguishes those with GAD from sub-clinical cases (Borkovec & Roemer, 1995; Freeston, Rhéaume, Letarte, Dugas, & Ladoucer, 1994).”
Quote in the paperSubstantial claim0 of 2 sources checked
- cites Borkovec & Roemer, 1995 source
- cites Freeston, Rhéaume, Letarte, Dugas, & Ladoucer, 1994 source
Interpretationown data
The findings support a model that emphasizes the relevance of experiential avoidance and distress about emotions in understanding GAD.
“The findings from the present study lend further support for a model that highlights the relevance of experiential avoidance and distress about emotions in understanding GAD.”
Quote in the paperSubstantial claim
- Rests on an assumption: Participants can accurately assess and report their internal experiences through self-report.
- Rests on an assumption: Observed differences between the GAD and non-GAD groups are attributable to GAD rather than to comorbid diagnoses.
Study design and conductreasoning
The lack of a comparison group with another Axis I diagnosis limits conclusions about the specificity of experiential avoidance in predicting GAD.
“Similarly, the lack of a comparison group with another Axis I diagnosis limits conclusions about the specificity of experiential avoidance in predicting GAD.”
Quote in the paperSubstantial claim
Premisecitation
Preliminary findings show that distress about emotions and avoidance of internal experiences share unique variance with GAD beyond chronic worry.
“Preliminary findings demonstrate that distress about emotions and avoidance of internal experiences share unique variance with GAD above and beyond chronic reports of worry (Roemer, Salters, Raffa, & Orsillo, 2005).”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Roemer, Salters, Raffa, & Orsillo, 2005 source
Interpretationreasoning
The use of extreme groups may not accurately reflect the generality of the variables in the general population.
“The use of such extreme groups, while providing robust power for statistical analyses, may not accurately reflect the generality of the variables of interest in the general population.”
Quote in the paperNot a substantial claim
Interpretationown data
Taken together, the findings suggest that distress and avoidance of internal experiences may be an important feature in understanding GAD.
“Taken collectively, these findings suggest that distress and avoidance of internal experiences may be an important feature in understanding GAD.”
Quote in the paperSubstantial claim
Study design and conductreasoning
Because the clinical group had co-occurring secondary disorders, it is unclear whether the observed differences were due to GAD or to the secondary diagnosis.
“Given the co-occurring secondary disorders in the clinical group, it is not clear whether the observed differences were specifically due to GAD, or the secondary diagnosis.”
Quote in the paperSubstantial claim
- Rests on an assumption: Observed differences between the GAD and non-GAD groups are attributable to GAD rather than to comorbid diagnoses.
Interpretationreasoning
The internal state elicited by uncertainty may motivate worry and avoidance.
“it may be the internal state elicited by uncertainty that motivates worry and avoidance.”
Quote in the paperSubstantial claim
Premisecitation
Theory and research suggest that treatments targeting experiential avoidance may improve outcomes for patients with GAD.
“Theory and research suggest treatments targeting experiential avoidance may enhance outcomes for patients with GAD (Roemer & Orsillo, 2002; 2007).”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Roemer & Orsillo, 2002; 2007
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Interpretationown data
The finding that distress about anxiety and experiential avoidance accounted for unique variance in intolerance of uncertainty and worry while controlling for depression replicates and extends prior results from a college analogue sample to a treatment-seeking GAD sample.
“This finding replicates and extends the results from a college analogue sample (Roemer et al., 2005) to a treatment-seeking sample diagnosed with GAD.”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Roemer et al., 2005 source
Interpretationown data
The GAD group's greater distress about depressive, positive, and angry emotions compared with controls suggests a broad intolerance of difficult and painful thoughts, feelings, and sensations.
“Individuals with GAD reported significantly more distress about depressive, positive, and angry emotions than those in the comparison group, suggesting a broad intolerance of difficult and painful thoughts, feelings and sensations”
Quote in the paperSubstantial claim
Premisecitation
Individuals with GAD have difficulty recognizing and describing their internal experiences.
“Mennin et al. (2005) have demonstrated that individuals with GAD have difficulty recognizing and describing their internal experiences.”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Mennin et al., 2005 source
Premisecitation
Experimental manipulations of intolerance of uncertainty show a direct relationship between high and low uncertainty and level of worrying.
“experimental manipulations of intolerance of uncertainty show a direct relationship between high and low uncertainty and level of worrying (Ladouceur, Gosselin, & Dugas, 2000).”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Ladouceur, Gosselin, & Dugas, 2000 source
Premisecitation
Basic research has demonstrated the unique contribution of intolerance of uncertainty to worry severity over and above depression and anxiety.
“basic research has demonstrated the unique contribution of intolerance of uncertainty in worry severity over and above the effects of depression and anxiety (Dugas et al., 1997)”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Dugas et al., 1997 source
Premisecitation
Roemer et al. (2005) found that reports of experiential avoidance and distress about emotions predicted GAD severity in a female analogue sample above and beyond shared variance with worry, anxiety, and depression.
“Roemer, Salters, Raffa, and Orsillo (2005) found that reports of experiential avoidance and distress about emotions predicted GAD severity in a female analogue sample of college students above and beyond the shared variance with worry, anxiety, and depression.”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Roemer, Salters, Raffa, and Orsillo, 2005 source

May combine two claims. 17
Classified as probably not a substantial claim. 16

May combine two claims.
Findingown data
Cross-validation correctly classified 98.5% of the total sample, with 97% of the GAD group and 100% of the non-GAD group correctly classified.
“a cross-validation process where the total sample was randomly split to generate the discriminant function and then tested on the other half of the sample, revealed 98.5% of the total sample was correctly classified (97% of the GAD group and 100% of the non-GAD group).”
Quote in the paperSubstantial claim
- Rests on an assumption: The AAQ measures experiential avoidance distinctly from general negative affectivity.
May combine two claims.
Findingown data
The discriminant function correctly classified 98.5% of the total sample in the original classification, with 97% of the GAD group and 100% of the non-GAD group correctly classified.
“Original classification results revealed 98.5% of the total sample was correctly classified (97% of the GAD group and 100% of the non-GAD group)”
Quote in the paperSubstantial claim
- Rests on an assumption: The AAQ measures experiential avoidance distinctly from general negative affectivity.
May combine two claims.
Premisecitation
Although CBT produces significant improvement in GAD symptoms compared with placebo and no-treatment, a significant minority of clients do not achieve high end-state functioning.
“Although cognitive-behavioral approaches produce significant improvement in GAD symptoms compared to placebo and no-treatment conditions, a significant minority of clients who receive this treatment do not achieve high levels of end-state functioning (Borkovec & Ruscio, 2001; Gould, Safren, Washington, & Otto, 2004).”
Quote in the paperSubstantial claim0 of 2 sources checked
- cites Borkovec & Ruscio, 2001
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Gould, Safren, Washington, & Otto, 2004
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given
The clinical group was self-selected by seeking treatment for GAD, while the control group was recruited to represent a healthy population.
“The participants in the clinical group were self-selected based on their decision to seek treatment for GAD, while those in the control group were recruited based on predetermined criteria to represent a healthy population.”
Quote in the paperNot a substantial claim
May combine two claims.
Interpretationown data
The findings provide partial support that distress and avoidance of internal experiences such as emotion are characteristic of GAD and may contribute to its development and maintenance.
“Despite these limitations, the findings from the present study provide partial support that distress and avoidance of internal experiences such as emotion are characteristic of GAD and may contribute to the development and maintenance of the disorder.”
Quote in the paperSubstantial claim
- Rests on an assumption: Participants can accurately assess and report their internal experiences through self-report.
- Rests on an assumption: Observed differences between the GAD and non-GAD groups are attributable to GAD rather than to comorbid diagnoses.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation
GAD is one of the most treatment-resistant anxiety disorders.
“GAD is also one of the most treatment resistant anxiety disorders (Roemer, Orsillo, & Barlow, 2002).”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites Roemer, Orsillo, & Barlow, 2002
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Premisecitation
Worrying before a fearful image reduces physiological reactivity in the short term but maintains a moderate response over time.
“worrying prior to a fearful image reduces physiological reactivity in the short term, although it maintains a moderate response over time (Borkovec & Hu, 1990).”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Borkovec & Hu, 1990 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Interpretationown data
The correlational analyses may have been under-powered because of the restricted range of scores on the PSWQ.
“It is possible that the correlational analyses were under-powered given the restricted range of scores on the PSWQ.”
Quote in the paperNot a substantial claim
May combine two claims.
Premisecitation
Worriers describe worrying as aversive but also endorse positive beliefs about worry.
“Despite concomitant reports that worriers describe the process of worrying as aversive (Ruscio & Borkovec, 2004; Wells, 1995), they also endorse positive beliefs about worry; that it might help them prepare for, problem solve, or superstitiously avoid future catastrophic events (e.g., Borkovec, Hazlett-Stevens, & Diaz, 1999).”
Quote in the paperSubstantial claim0 of 3 sources checked
- cites Ruscio & Borkovec, 2004 source
- cites Wells, 1995 source
- cites Borkovec, Hazlett-Stevens, & Diaz, 1999 source
May combine two claims.
Study design and conductreasoning
The study relied on self-report to assess experiential avoidance and did not account for response biases or experiences outside awareness.
“Most importantly, this study relied on self-report methodology to assess experiential avoidance and did not account for response biases and experiences that may be outside of awareness.”
Quote in the paperSubstantial claim
- Rests on an assumption: Participants can accurately assess and report their internal experiences through self-report.
May combine two claims.
Premisecitation
Roemer and colleagues (Study 2; 2005) found a moderate to large effect size for the association between distress about depressive emotions and worry in a treatment-seeking GAD sample, although the association was not statistically significant.
“Roemer and colleagues (Study 2; 2005) found a moderate to large effect size for the association between distress about depressive emotions and worry in a treatment-seeking sample with GAD, although the association was not statistically significant.”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites Roemer and colleagues (Study 2; 2005)
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Premisecitation
Borkovec (1994) proposed that worry serves an avoidant function.
“Borkovec (1994) proposed that worry serves an avoidant function.”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Borkovec, 1994
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitation
The DASS-21 has three factors, good to excellent internal consistency, and strong correlations with other measures of general distress in clinical and nonclinical samples.
“Factor analysis of the 21-item version yields three factors and internal consistency for the subscales range from good to excellent (Antony, Bieling, Cox, Enns, & Swinson, 1998). The measure also demonstrates strong correlations with other measures of general distress in clinical (Antony et al., 1998) and nonclinical samples (Henry & Crawford, 2005).”
Quote in the paperNot a substantial claim0 of 2 sources checked
- cites Antony, Bieling, Cox, Enns, & Swinson, 1998 source
- cites Henry & Crawford, 2005 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitation
The ACS has convergent validity with measures of neuroticism and predictive validity in lab-induced fear of bodily sensations related to panic among college students while controlling for state and trait anxiety.
“Convergent validity has been established in a college analogue sample with measures of neuroticism; further the ACS demonstrated predictive validity in lab induced fear of bodily sensations related to panic among college students while controlling for state and trait anxiety (Berg, Shapiro, Chambless, & Ahrens, 1998).”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites Berg, Shapiro, Chambless, & Ahrens, 1998 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitation
The ADIS-IV has interrater reliability for GAD diagnostic category with a kappa of .67 at the same site and using the same training procedures.
“Interrater reliability of GAD diagnostic category over a two-week period yielded a kappa coefficient of .67 at the same site the current study was conducted and using the same training procedures (Brown, Di Nardo, Lehman, & Campbell, 2001).”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites Brown, Di Nardo, Lehman, & Campbell, 2001
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Premisecitation
Intolerance of uncertainty is proposed to be a defining feature of individuals with GAD.
“Intolerance of uncertainty, defined as the “tendency to react negatively on an emotional, cognitive, and behavioral level to uncertain situations and events” (Dugas, Buhr, & Ladouceur, 2004, p. 143), is also proposed to be a defining feature of individuals with GAD.”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Dugas, Buhr, & Ladouceur, 2004
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitation
The IUS is strongly correlated with worry while controlling for anxiety and depression, supporting it as a distinct construct.
“Research demonstrates that intolerance of uncertainty is strongly correlated with worry while controlling for anxiety and depression, supporting it as a distinct construct (Freeston et al., 1994).”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites Freeston et al., 1994 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitation
The IUS has excellent internal consistency (α = .94) and test-retest reliability of r = .74 over five weeks.
“Internal consistency was excellent for the English version (α = .94), with a reliability coefficient of r = .74 for five week test-retest.”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites Buhr & Dugas, 2002 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitation
The ACS has moderate to excellent internal consistency for the total scale and subscales.
“Internal consistency for the total scale as well as for subscales indicate moderate to excellent reliability (Williams et al., 1997).”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites Williams et al., 1997 source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitation
The AAQ significantly correlates with other measures of psychopathology and more specific measures of experiential avoidance even when controlling for social desirability.
“The AAQ significantly correlates with other measures of psychopathology and more specific measures of experiential avoidance even when controlling for social desirability (Hayes et al., 2004).”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites Hayes et al., 2004 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premiseown data
These findings are constrained by a female-only sample and the absence of a clinical sample for comparison.
“However, these findings are constrained by a female-only sample and the absence of a clinical sample for comparison.”
Quote in the paperNot a substantial claim
Classified as probably not a substantial claim. May combine two claims.
Premisecitation
Intolerance of uncertainty is conceptualized as a cognitive schema for perceiving the environment, while worry is a mental reaction to uncertainty.
“Specifically, intolerance of uncertainty is conceptualized as a cognitive schema with which an individual perceives the environment, while worry is proposed to be a mental reaction to the uncertainty (Dugas, et al., 2004).”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Dugas, et al., 2004
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim. May combine two claims.
Premisecitation
Distress about emotions and difficulties with emotion regulation contribute unique variance to GAD severity and significantly discriminate between individuals with and without GAD.
“distress about emotions (particularly anxiety and depression) and difficulties with emotion regulation contribute unique variance to GAD severity, and significantly discriminate between individuals with and without GAD (Mennin, Heimberg, Turk, & Fresco, 2005).”
Quote in the paperSubstantial claim0 of 1 sources checked
- cites Mennin, Heimberg, Turk, & Fresco, 2005 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitation
The PSWQ has excellent internal consistency (α .93-.97) and test-retest reliability of r = .93 at one month.
“In the validation study, the measure showed excellent internal consistency (α range = .93-.97) and test-retest reliability of r = .93 at one month.”
Quote in the paperNot a substantial claim0 of 1 sources checked
- cites Meyer, Miller, Metzger, & Borkovec, 1990 source

24 of 24

The paper relies on this without support.
The relationship between experiential avoidance and distress about emotions with intolerance of uncertainty had not been examined before this study.
“To our knowledge, the relationship between experiential avoidance and distress about emotions with intolerance of uncertainty has yet to be examined.”
The paper relies on this without support.
Participants can accurately assess and report their internal experiences through self-report.
“Self-report methodology can be considered valid to the extent that the individual responding can accurately assess the domain to which she or he is responding.”
The paper relies on this without support.
The depression subscale of the DASS-21 adequately controls for negative affect.
“Only the depression subscale was used in the present study to partially account for negative affect.”
The paper relies on this without support.
Observed differences between the GAD and non-GAD groups are attributable to GAD rather than to comorbid diagnoses.
“Given the co-occurring secondary disorders in the clinical group, it is not clear whether the observed differences were specifically due to GAD, or the secondary diagnosis.”
The paper relies on this without support.
The AAQ measures experiential avoidance distinctly from general negative affectivity.
“It has been argued the AAQ may not distinguish experiential avoidance from other theoretical constructs such as general negative affectivity (e.g., Zvolensky, Feldner, Leen-Feldner, & Yartz, 2005).”

5 of 5

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?

EA is uniquely associated with GAD symptoms.
“Moreover, there is evidence that EA is uniquely associated with GAD symptoms (Lee, Orsillo, Roemer, & Allen, 2010; Roemer, Salters, Raffa, & Orsillo, 2005).”
From Reductions in experiential avoidance as a mediator of change in symptom outcome and quality of life in acceptance-based behavior therapy and applied relaxation for generalized anxiety disorder (2016) · cites this paper as Lee, Orsillo, Roemer, & Allen, 2010
The Results (GAD versus Non-GAD Comparisons; page not provided) report greater experiential avoidance in the GAD group than in non-anxious controls after controlling for depressive symptoms. But the Discussion (page not provided) says that secondary diagnoses and the lack of another clinical comparison group prevent conclusions about whether experiential avoidance is specific to GAD, so the claimed unique association is not established. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Over time, experiential avoidance can impair psychosocial functioning.
“While EA may appear to be effective in the short term, it can greatly interfere with psychosocial functioning in the long term.”
From Reductions in experiential avoidance as a mediator of change in symptom outcome and quality of life in acceptance-based behavior therapy and applied relaxation for generalized anxiety disorder (2016) · cites this paper as Lee et al., 2010
The paper’s model (section labeled Abstract; page not provided) describes avoidance efforts intended to reduce distress and links struggling with internal experiences to behavioral restriction and dissatisfaction. It also reports a short-term reduction in physiological reactivity from worry. These passages support the general contrast, but the paper does not establish that experiential avoidance itself greatly impairs psychosocial functioning over the long term. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Negative reactivity to emotions, beliefs that worries are dangerous and uncontrollable, and intolerance of uncertainty are greater in GAD than in lower-symptom individuals.
“For example, individuals with symptoms of GAD report greater negative reactivity toward their emotions (Lee, Orsillo, Roemer, & Allen, 2010; Mennin, Heimberg, Turk, & Fresco, 2005), view their worrisome thoughts as more dangerous and uncontrollable (Wells & Carter, 1999), and report intolerance of thoughts and feelings related to uncertainty (Dugas, Gagnon, Ladouceur, & Freeston, 1998) compared to individuals with lower levels of GAD symptomatology.”
From An Acceptance-Based Behavioral Therapy for Individuals With Generalized Anxiety Disorder (2013) · cites this paper as Lee, Orsillo, Roemer, & Allen, 2010
Treatment-seeking GAD patients report greater distress about emotions, emotion regulation difficulties, experiential avoidance, and lower mindfulness than people without GAD.
“Further, treatment-seeking patients with GAD report significantly more distress about emotions,[29, 31] difficulties with emotion regulation,[16, 29] and experiential avoidance,[31] as well as diminished levels of mindfulness[16] than do individuals without GAD.”
From The role of values-consistent behavior in generalized anxiety disorder. (2011) · cites this paper as [31]
The model suggests that people with generalized anxiety disorder have critical, judgmental reactivity toward their emotional responses.
“and a critical, judgmental reactivity toward their emotional responses (e.g., Lee, Orsillo, Roemer, & Allen, 2010; Llera & Newman, 2010; Mennin, Heimberg, Turk, & Fresco, 2005) and thoughts (Wells & Carter, 1999).”
From A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder (2013) · cites this paper as Lee et al., 2010

This reaction to internal experiences motivates people with generalized anxiety disorder to use experiential avoidance strategies, including worry.
“This reaction to internal experiences motivates individuals with GAD to engage in experiential avoidance (e.g., Lee et al., 2010) using a variety of strategies including worry, the central defining feature of GAD.”
From A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder (2013) · cites this paper as Lee et al., 2010
Compared with people who have lower GAD symptoms, those with GAD symptoms report more negative reactivity to emotions, see worrisome thoughts as more dangerous and uncontrollable, and are less tolerant of uncertainty-related thoughts and feelings.
“For example, individuals with symptoms of GAD report greater negative reactivity toward their emotions (Lee, Orsillo, Roemer, & Allen, 2010; Mennin, Heimberg, Turk, & Fresco, 2005), view their worrisome thoughts as more dangerous and uncontrollable (Wells & Carter, 1999), and report intolerance of thoughts and feelings related to uncertainty (Dugas, Gagnon, Ladouceur, & Freeston, 1998) compared to”
From An Acceptance-Based Behavioral Therapy for Individuals With Generalized Anxiety Disorder (2013) · cites this paper as Lee et al., 2010
Experiential avoidance has been shown to differentiate individuals with and without a diagnosis of generalized anxiety disorder.
“and has been shown to differentiate those with and without a diagnosis of generalized anxiety disorder (Lee, Orsillo, Roemer, & Allen, 2010).”
From A Fresh Look at Potential Mechanisms of Change in Applied Relaxation for Generalized Anxiety Disorder: A Case Series (2012) · cites this paper as Lee, Orsillo, Roemer, & Allen, 2010
Individuals with GAD report more distress about emotional responses than individuals without GAD.
“Individuals with GAD report more distress about emotional responses (Lee, Orsillo, Roemer, & Allen, 2010)”
From Decentering as a potential common mechanism across two therapies for generalized anxiety disorder (2015) · cites this paper as Lee, Orsillo, Roemer, & Allen, 2010
Individuals with GAD report more experiential avoidance than individuals without GAD.
“more experiential avoidance (Lee et al., 2010)”
From Decentering as a potential common mechanism across two therapies for generalized anxiety disorder (2015) · cites this paper as Lee et al., 2010
Research has shown that individuals with GAD symptoms report greater negative reactivity towards their emotions than individuals with lower GAD symptomatology.
“research has consistently shown that individuals with symptoms of GAD report greater negative reactivity towards their emotions (Lee et al., 2010; Mennin, Heimberg, Turk, & Fresco, 2005)”
From Decentering as a potential common mechanism across two therapies for generalized anxiety disorder (2015) · cites this paper as Lee et al., 2010
Avoidance efforts can paradoxically increase distress and restrict lives.
“Avoidance efforts can both paradoxically increase distress and also restrict lives (Hayes et al., 1996; Lee et al., 2010; Wegner, 2011).”
From Reductions in experiential avoidance as a mediator of change in symptom outcome and quality of life in acceptance-based behavior therapy and applied relaxation for generalized anxiety disorder (2016) · cites this paper as Lee et al., 2010
Elevated levels of experiential avoidance in GAD patients compared to non-clinical controls have been observed.
“Moreover, elevated levels of experiential avoidance in GAD patients compared to non-clinical controls have been observed (Lee et al. 2010; Roemer et al. 2005).”
From Experiential avoidance and bordering psychological constructs as predictors of the onset, relapse and maintenance of anxiety disorders: One or many? (2017) · cites this paper as Lee et al. 2010
Empirical associations exist between EA and harmful psychological and behavioral problems such as substance and alcohol misuse, PTSD, depression, and anxiety.
“Relatedly, the empirical associations between EA and a number of harmful psychological and behavioral problems such as substance and alcohol misuse, post-traumatic stress disorder (PTSD), depression, and anxiety [6,7,8] support this premise.”
From Measuring Experiential Avoidance: Evidence toward Multidimensional Predictors of Trauma Sequelae (2017) · cites this paper as [7]

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

ConsistentF(5, 58) = 22.8reported p < .0005 · recomputed p < .001
“F(5,58) = 22.80, p < .0005”
Consistentχ²(5) = 101.64reported p < .0005 · recomputed p < .001
“χ2(5, N = 66) = 101.64, p < .0005”

2 of 2

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.

Total participant count does not reconcile with group counts
Minor
One place says 90 participants were recruited, with 50 clinical and 41 non-GAD participants described, while elsewhere the final analyzable sample is 33 clinical and 33 non-GAD participants. Those numbers do not reconcile because 50 + 41 = 91, not 90, and the exclusions described do not match the final counts cleanly.
Discriminant-function variance is overstated
Minor
With one discriminant function, Wilks' Λ of .19 implies an explained variance fraction of 1 − .19 = .81, or 81%, rather than 90%.
Reported 0.9 · recomputed 0.81

2 of 2

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“Thus, treatments that integrate the encouragement of acceptance of internal experiences (Ladouceur et al., 2000; Mennin, 2004; Roemer & Orsillo, 2007) with existing cognitive behavioral approaches may enhance outcome (Dugas & Koerner, 2005) and improve quality of life among those seeking treatment…”
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“Prevalence rates estimate that GAD affects 5 to 8% of the population (Kessler, Walters, & Wittchen, 2004), andmedical costs for treating GAD, controlling for demographic factors and other diseases, place it among the most expensive anxiety disorders to treat, second only to posttraumatic stress disorder (Marciniak et…”
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The Nature, Diagnosis, and Treatment of Neuroticism: Back to the Future
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“This reaction to internal experiences motivates individuals with GAD to engage in experiential avoidance (e.g., Lee et al., 2010) using a variety of strategies including worry, the central defining feature of GAD.”
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“It is associated with high levels of worry and catastrophic predictions plus counterproductive coping behavior.(48) Patients susceptible to motor fluctuations and who find the experience P A R K I N S O N ’ S D I S E A S E M O T O R S U B T Y P E S A N D M O O D”
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Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder
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Self-citation
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“…and repetitive behaviors such as insistence on sameness and inflexible adherence to routines in ASD may function as strategies to avoid uncertainty by preventing unexpected events and controlling one’s environment [e.g., Lidstone et al., 2014; Rodgers, Glod, Connolly, & McConachie, 2012].”
Background
Intolerance of uncertainty and emotion regulation: A meta-analytic and systematic review
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Anxiety Sensitivity, Experiential Avoidance, and Mindfulness Among Younger and Older Adults: Age Differences in Risk Factors for Anxiety Symptoms
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“study confirms previous findings underlying the relationship between EA and anxiety-related pathology (Andrew & Dulin, 2007; Briggs & Price, 2009; Glick & Orsillo, 2011; Kashdan et al., 2006; Lee et al., 2010; Mahaffey et al., 2013).”
Result
The role of values-consistent behavior in generalized anxiety disorder.
Michelson, S. E., Lee, J. K., Orsillo, S. M., & Roemer, L. (2011) · Depression and Anxiety · doi:10.1002/da.20793 · Cited by 84 · see citing works
“Further, treatment-seeking patients with GAD report significantly more distress about emotions,[29,31] difficulties with emotion regulation,[16,29] and experiential avoidance,[31] as well as diminished levels of mindfulness[16] than do individuals without GAD.”
BackgroundSelf-citation
Decentering as a potential common mechanism across two therapies for generalized anxiety disorder
Hayes-Skelton, S. A., Calloway, A., Roemer, L., & Orsillo, S. M. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0038305 · Cited by 83 · see citing works
“…one engages in. Individuals with GAD report more distress about emotional responses (Lee, Orsillo, Roemer, & Allen, 2010), more experiential avoidance (Lee et al., 2010), and less engagement in meaningful activities (Michelson, Lee, Orsillo, & Roemer, 2011) than those without a diagnosis of GAD.”
BackgroundResultSelf-citation
Anxiety in anorexia nervosa and its management using family-based treatment.
Hildebrandt, T., Bacow, T., Markella, M., & Loeb, K. (2012) · European eating disorders review · doi:10.1002/erv.1071 · Cited by 81 · see citing works
Intolerance of uncertainty and difficulties in emotion regulation: Proposal for an integrative model of generalized anxiety disorder
Ouellet, C., Langlois, F., Provencher, M. D., & Gosselin, P. (2019) · European Review of Applied Psychology · doi:10.1016/j.erap.2019.01.001 · Cited by 79 · see citing works
Functional Outcome in Bipolar Disorder: The Big Picture
Levy, B., & Manove, E. E. (2011) · Depression Research and Treatment · doi:10.1155/2012/949248 · Cited by 75 · see citing works
“is avoidance [110], people with BD who experience cognitive impairment may tend to withdraw from psychosocial”
Background
Reductions in experiential avoidance as a mediator of change in symptom outcome and quality of life in acceptance-based behavior therapy and applied relaxation for generalized anxiety disorder
Eustis, E. H., Hayes-Skelton, S. A., Roemer, L., & Orsillo, S. M. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2016.09.012 · Cited by 70 · see citing works
Self-citation
Experiential avoidance and bordering psychological constructs as predictors of the onset, relapse and maintenance of anxiety disorders: One or many?
Spinhoven, P., van Hemert, A. M., & Penninx, B. W. J. H. (2017) · Cognitive Therapy and Research · doi:10.1007/s10608-017-9856-7 · Cited by 68 · see citing works
The role of psychological flexibility in the relationship between parent and adolescent distress
Moyer, D. N., & Sandoz, E. K. (2015) · Journal of Child and Family Studies · doi:10.1007/s10826-014-9947-y · Cited by 67 · see citing works
“Psychological inflexibility has been linked to specific forms of psychopathology (Kashdan et al. 2006), including generalized anxiety disorder (Lee et al. 2010) and depression (Cribb et al. 2006; Nolen-Hoeksema et al. 2008).”
Background
Integrating and differentiating personality and psychopathology in cognitive behavioral therapy
Sauer-Zavala, S. E., Southward, M. W., & Semcho, S. (2020) · Journal of Personality · doi:10.1111/jopy.12602 · Cited by 53 · see citing works
“There is ample evidence linking these processes to DSM disorder onset and severity (e.g., Boelen et al., 2010; Boswell et al., 2013; Lee et al., 2010), as well as to the amplification of discrete emotional experiences (e.”
Background
A Contemporary View of Applied Relaxation for Generalized Anxiety Disorder
Hayes-Skelton, S., Roemer, L., Orsillo, S., & Borkovec, T. (2013) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2013.777106 · Cited by 54 · see citing works
“This experiential avoidance, or the internal strategies aimed at suppressing anxious thoughts, feelings, or sensations, decreasing their frequency, or changing their form (e.g., Hayes et al., 1996) differentiates those with and without a diagnosis of GAD (Lee et al., 2010).”
BackgroundSelf-citation
Is Rumination after Bereavement Linked with Loss Avoidance? Evidence from Eye-Tracking
Eisma, M. C., Schut, H. A. W., Stroebe, M., van den Bout, J., Stroebe, W., & Boelen, P. A. (2014) · PLoS ONE · doi:10.1371/journal.pone.0104980 · Cited by 56 · see citing works
“, [17,20,23,25–29,51–53]), diverging theories exist regarding what mechanisms underlie an avoidant function of rumination and worry [17,21–22].”
Mindfulness and acceptance-based behavioral therapies for anxiety disorders.
Roemer, L., Williston, S. K., Eustis, E. H., & Orsillo, S. M. (2013) · Current Psychiatry Reports · doi:10.1007/s11920-013-0410-3 · Cited by 46 · see citing works
“1 Lee et al., 2010; Hayes et al., 1996; 2 Borkovec et al., 2004; 3 Borkovec & Roemer, 1995 Experiential Avoidance”
BackgroundSelf-citation
Fear of COVID-19 lead to procrastination among Turkish university students: The mediating role of intolerance of uncertainty
Doğanülkü, H. A., Korkmaz, O., Griffiths, M. D., & Pakpour, A. H. (2021) · BMC Psychology · doi:10.1186/s40359-021-00681-9 · Cited by 46 · see citing works
“On the other hand, among individuals with a high level of intolerance of uncertainty, the avoidance response functions as a coping strategy, and individuals use the avoidance response in the face of uncertainties that make them feel psychologically uncomfortable [54].”
Background
Self-conscious emotions in worry and generalized anxiety disorder
Schoenleber, M., Chow, P. I., & Berenbaum, H. (2014) · British Journal of Clinical Psychology · doi:10.1111/bjc.12047 · Cited by 36 · see citing works
Factor Structure and Incremental Validity of the Original and Modified Versions of the Difficulties in Emotion Regulation Scale
Benfer, N., Bardeen, J. R., Fergus, T. A., & Rogers, T. A. (2018) · Journal of Personality Assessment · doi:10.1080/00223891.2018.1492927 · Cited by 33 · see citing works
In the mind's eye: The late positive potential to negative and neutral mental imagery and intolerance of uncertainty
MacNamara, A. (2017) · Psychophysiology · doi:10.1111/psyp.13024 · Cited by 35 · see citing works
Engaging in Risky and Impulsive Behaviors to Alleviate Distress Mediates Associations Between Intolerance of Uncertainty and Externalizing Psychopathology
Sadeh, N., & Bredemeier, K. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_456 · Cited by 35 · see citing works
An Acceptance-Based Behavioral Therapy for Individuals With Generalized Anxiety Disorder
Hayes-Skelton, S. A., Orsillo, S. M., & Roemer, L. (2013) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2011.02.005 · Cited by 34 · see citing works
Self-citation
Post-stroke neuronal circuits and mental illnesses.
Naghavi, F. S., Koffman, E. E., Lin, B., & Du, J. (2019) · Europe PMC (PubMed Central) · Cited by 29 · see citing works
Emotion regulation mediates the relation between intolerance of uncertainty and emotion difficulties: A longitudinal investigation
Sahib, A., Chen, J., Cárdenas, D., Calear, A. L., & Wilson, C. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.08.056 · Cited by 34 · see citing works
Incorporating Mindfulness and Acceptance-Based Strategies in the Behavioral Treatment of Generalized Anxiety Disorder
Roemer, L., Fuchs, C., & Orsillo, S. M. (2014) · Mindfulness-Based Treatment Approaches · doi:10.1016/b978-0-12-416031-6.00005-0 · Cited by 30 · see citing works
Self-citation
A Fresh Look at Potential Mechanisms of Change in Applied Relaxation for Generalized Anxiety Disorder: A Case Series
Hayes-Skelton, S. A., Usmani, A., Lee, J. K., Roemer, L., & Orsillo, S. M. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2011.12.005 · Cited by 29 · see citing works
Self-citation
Impact of Parenting Styles on Psychological Flexibility Among Adolescents of Pakistan: A Cross-Sectional Study
Bibi, A., Hayat, R., Hayat, N., Zulfiqar, S., Shafique, N., & Khalid, M. A. (2021) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-021-00754-z · Cited by 34 · see citing works
Brief Report: The Impact of Sensory Hypersensitivity and Intolerance of Uncertainty on Anxiety in Williams Syndrome
Uljarević, M., Labuschagne, I., Bobin, R., Atkinson, A., & Hocking, D. R. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3631-9 · Cited by 25 · see citing works
“We speculate that increased generalized anxiety and obsessive compulsive symptoms in WS (Hocking 2017) might be more tightly linked to IU consistent with typically developing child and adult populations (e.g. Carleton et al. 2012; Lee et al. 2010), whereas the higher levels of specific phobias in ASD might be driven p…”
Background
Exploring DBT skills training as a treatment avenue for generalized anxiety disorder
Malivoire, B. L. (2020) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12339 · Cited by 25 · see citing works
Efficacy of an acceptance-based group behavioral therapy for generalized anxiety disorder.
Almeida Sampaio, T. P., Jorge, R. C., Martins, D. S., Gandarela, L. M., Hayes‐Skelton, S., Bernik, M. A., & Lotufo‐Neto, F. (2020) · Depression and Anxiety · doi:10.1002/da.23021 · Cited by 23 · see citing works
Cognitive processes across anxiety disorders related to intolerance of uncertainty: Clinical review
Haegen, M. V., & Étienne, A.-M. (2016) · Cogent Psychology · doi:10.1080/23311908.2016.1215773 · Cited by 22 · see citing works
Sex Differences in Psychological Factors Associated with Social Discounting
Olson, E. A., Rosso, I. M., Demers, L. A., Divatia, S. C., & Killgore, W. D. S. (2015) · Journal of Behavioral Decision Making · doi:10.1002/bdm.1876 · Cited by 23 · see citing works
Aversive Indecisiveness Predicts Risks for and Symptoms of Anxiety and Depression Over Avoidant Indecisiveness
Lauderdale, S. A., Martin, K. J., & Moore, J. M. (2018) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-018-0302-x · Cited by 21 · see citing works
Janina Scarlet: Superhero Therapy: A Hero’s Journey Through Acceptance and Commitment Therapy
Fradkin, C. (2017) · Journal of Youth and Adolescence · doi:10.1007/s10964-017-0658-8 · Cited by 20 · see citing works
“While avoidance may shield us from our demons in the short term, over time its presence is destructive (Hayes et al. 1996; Lee et al. 2010; Wegner 2011).”
Background
Evaluating the Indirect Effects of Trait Mindfulness Facets on State Tripartite Components Through State Rumination and State Experiential Avoidance
Parsons, E. M., Dreyer-Oren, S. E., Magee, J. C., & Clerkin, E. M. (2019) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000993 · Cited by 19 · see citing works
“In addition to connections between the mindfulness facets and experiential avoidance, experiential avoidance plays an integral role in the maintenance of anxiety disorders (Feldner et al., 2003; Lee et al., 2010; Roemer et al., 2005) and depression (Cribb et al.”
Background
Measuring Experiential Avoidance: Evidence toward Multidimensional Predictors of Trauma Sequelae
Lewis, M., & Naugle, A. (2017) · Behavioral Sciences · doi:10.3390/bs7010009 · Cited by 20 · see citing works
Associations between Perceived Parental Overprotection, Experiential Avoidance, and Anxiety
Fulton, J. J., Kiel, E. J., Tull, M. T., & Gratz, K. L. (2014) · Journal of Experimental Psychopathology · doi:10.5127/jep.034813 · Cited by 18 · see citing works
“Finally, the results of this study provide further support for theoretical and clinical literature suggesting that experiential avoidance contributes to the development, maintenance, and exacerbation of anxiety in young adults (Hayes et al., 2004, 2006; Lee et al., 2010; Tull et al., 2004).”
Result
Reliability and Validity of a Brief Version of the Intolerance of Uncertainty Scale in Outpatients with Psychosis
Bredemeier, K., McCole, K., Luther, L., Beck, A. T., & Grant, P. M. (2018) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-018-9714-2 · Cited by 14 · see citing works
Dynamic measures of anxiety-related threat bias: Links to stress reactivity
Egan, L. J., & Dennis‐Tiwary, T. A. (2018) · Motivation and Emotion · doi:10.1007/s11031-018-9674-6 · Cited by 16 · see citing works
Isolating the Effects of Mindfulness Training Across Anxiety Disorder Diagnoses in the Unified Protocol
Woods, B. K., Sauer-Zavala, S. E., Farchione, T. J., & Barlow, D. H. (2020) · Behavior Therapy · doi:10.1016/j.beth.2020.01.001 · Cited by 16 · see citing works
Adaptation and psychometric validation of Hindi version of the Behavioural Emotion Regulation Questionnaire
Bhat, N. A., Devdutt, J., Johnson, J. A., & Roopesh, B. N. (2021) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2021.102730 · Cited by 14 · see citing works
Janina Scarlet: Harry Potter Therapy: An Unauthorized Self-Help Book from the Restricted Section
Fradkin, C. (2017) · Journal of Youth and Adolescence · doi:10.1007/s10964-017-0780-7 · Cited by 12 · see citing works
Effect of Psychotherapy on Intolerance of Uncertainty: A Systematic Review and Meta‐Analysis
Näsling, J., Åström, E., Jacobsson, L., & Ljungberg, J. K. (2024) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.3026 · Cited by 12 · see citing works
A non-linear dynamical approach to belief revision in cognitive behavioral therapy
Kronemyer, D., & Bystritsky, A. (2014) · Frontiers in Computational Neuroscience · doi:10.3389/fncom.2014.00055 · Cited by 10 · see citing works
Comparing the effectiveness of acceptance-based behavior therapy and applied relaxation on acceptance of internal experiences, engagement in valued actions and quality of life in generalized anxiety disorder.
Zargar, F., Farid, A. A. A., Atef-Vahid, M. K., Afshar, H., & Omidi, A. (2013) · Europe PMC (PubMed Central) · Cited by 12 · see citing works
Associations among internalized and perceived stigma, state mindfulness, self-efficacy, and depression symptoms among men who have sex with men in China: A serial mediation model
Liu, C., Yuan, G. F., Li, X., Fung, H. W., Wong, M. Y. C., Zhao, J., & Feng, X. (2023) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2023.06.001 · Cited by 10 · see citing works
Investigating How Intolerance of Uncertainty and Emotion Regulation Predict Experiential Avoidance in Non-Clinical Participants
Giuseppe, K. D., & Taylor, A. (2021) · Psychological Studies · doi:10.1007/s12646-021-00602-1 · Cited by 10 · see citing works
Examining incremental explanatory power in accounting for worry severity: negative metacognitive beliefs uniquely predict worry severity following a worry episode
Fergus, T. A., & Wheless, N. E. (2018) · Anxiety Stress & Coping · doi:10.1080/10615806.2018.1479828 · Cited by 10 · see citing works
A Structural Equation Modelling on the Factors Affecting Intolerance of Uncertainty and Worry Among a Select Group of Filipino Elderly
de Guzman, A. B., Lacao, R. A., & Larracas, C. (2014) · Educational Gerontology · doi:10.1080/03601277.2014.918837 · Cited by 10 · see citing works
“However, most of these studies had young adults as respondents (Lee et al., 2010; Dugas & Koerner, 2005; Rosen & Knauper, 2009) compared to the few investigations which involved the elderly group (Nuevo et al.”
BackgroundResultInfluential
Acceptance and Commitment Therapy in Genetic Counselling: A Case Study of Recurrent Worry.
Broley, S. (2013) · Journal of Genetic Counseling · doi:10.1007/s10897-012-9558-y · Cited by 10 · see citing works
The characteristics of event-related potentials in generalized anxiety disorder: A systematic review and meta-analysis
Xie, C. P., Xue, C., Li, Y., Liu, X.-B., Zhong, D., Jin, Q., Li, J., & Jin, R. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.12.016 · Cited by 8 · see citing works
Computer-Mediated Communication (CMC) and Anxiety in Adolescence: Preference for CMC, Social Media Burden, and Attention Bias to Threat
de Rutte, J. L., Dennis‐Tiwary, T. A., & Roy, A. K. (2024) · Affective Science · doi:10.1007/s42761-024-00253-1 · Cited by 7 · see citing works
“Individuals exhibiting symptoms of generalized anxiety disorder (GAD) which is characterized by excessive worry and intolerance of uncertainty (Lee et al., 2010) may be particularly vulnerable to exacerbating effects of CMC.”
The Association between Metacognitions and Worry: The Mediator Role of Experiential Avoidance Strategies
Yıldırım, J. C., & Bahtiyar, B. (2022) · The Journal of Psychology · doi:10.1080/00223980.2022.2107977 · Cited by 7 · see citing works
Exploration of caregiver behavior on fear of emotion, spirituality, and self-compassion
Farnsworth, J. K., Mannon, K., Sewell, K., Connally, M. L., & Murrell, A. (2016) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2016.07.004 · Cited by 5 · see citing works
Investigating experiential avoidance as a mechanism of action in a mindfulness intervention
Weinrib, A. (2011) · doi:10.17077/etd.ol97lozj · Cited by 6 · see citing works
Do appearance related safety behaviors contribute to distress intolerance? A Multi-method examination.
Patel, T. A., Zech, J. M., & Cougle, J. R. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104617 · Cited by 4 · see citing works
CORRELATION AMONG EXPERIENTIAL AVOIDANCE, ANXIETY SENSITIVITY AND BEHAVIORAL INHIBITION SYSTEM IN GENERALIZED ANXIETY DISORDER AND PANIC DISORDER PATIENTS
Görgülü, S. A., Baykan, H., & Karlıdere, T. (2023) · Psychiatria Danubina · doi:10.24869/psyd.2023.344 · Cited by 5 · see citing works
“In addition to studies demonstrating the relationship between experiential avoidance and GAD (Lee et al. 2010, Roemer et al. 2005), in the clinical sample, higher levels of experiential avoidance have been ob - served in the group with panic disorder or a history of panic attacks compared to the…”
Background
Integrating Mindfulness and Acceptance Into Traditional Cognitive Behavioral Therapy During the COVID-19 Pandemic: A Case Study of an Adult Man With Generalized Anxiety Disorder
Garner, A. R., & Stuart, G. L. (2023) · Clinical Case Studies · doi:10.1177/15346501221123568 · Cited by 5 · see citing works
“This worry serves as means of avoiding threatening, unpleasant experiences (Lee et al., 2010).”
Background
Experiential Avoidance
Goodman, F. R., Larrazabal, M. A., West, J. T., & Kashdan, T. B. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108140416.010 · Cited by 8 · see citing works
Athlete and Practitioner Insights Regarding a Novel Coping-Oriented Personal-Disclosure Mutual-Sharing Intervention in Youth Soccer
Evans, A. L., Morris, R. M., Barker, J. B., et al. (2018) · The Sport Psychologist · doi:10.1123/tsp.2017-0125 · Cited by 5 · see citing works
“It is today that counts, and today everything is fine”: coping strategies utilized by parents of children treated for cancer who seek psychological support - a qualitative study
Lundgren, J., Reuther, C., Farrand, P. A., Lutvica, N., Thiblin, E., von Essén, L., & Woodford, J. (2025) · BMC Psychology · doi:10.1186/s40359-025-02860-4 · Cited by 5 · see citing works
“The finding parents use avoidant coping strategies further supports the use of behavioral activation and worry management as techniques designed to reduce behavioral and experiential avoidance, which are maintaining factors in depression and GAD [80, 81].”
The relationship between momentary experiential avoidance and anxiety symptoms
Sain, K. S., Lord, K. A., Knowles, K. A., Everhardt, K., & Tolin, D. F. (2024) · Anxiety Stress & Coping · doi:10.1080/10615806.2024.2383769 · Cited by 6 · see citing works
“EA is thought to maintain psychological distress by providing short-term reduction in unwanted internal experiences, while maintaining long-term distress through negative reinforcement (Hayes et al., 1996; Lee et al., 2010; Wegner, 2011).”
Flip the tweet – the two-sided coin of entrepreneurial empathy and its ambiguous influence on new product development
Kurz, K., Bock, C., & Hanschur, L. (2024) · Journal of Business Venturing · doi:10.1016/j.jbusvent.2023.106378 · Cited by 5 · see citing works
Seroprevalence of COVID-19 and Psychological Distress among Front Liners at the Universiti Malaysia Sabah Campus during the Third Wave of COVID-19
Hijazi, M. H. A., Jeffree, M. S., Pang, N. T. P., Rahim, S. S. S. A., Omar, A., Ahmedy, F., Hijazi, M. H. A., Hassan, M. R., Hod, R., Nawi, A. M., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19116840 · Cited by 4 · see citing works
Parents’ Obedience Beliefs and Autonomy Granting: The Role of Child Externalizing and Parent Anxiety
Partain, J. A., Nelson, J. A., & Hafiz, M. (2021) · Journal of Child and Family Studies · doi:10.1007/s10826-021-02087-y · Cited by 6 · see citing works
“Further, past research shows individuals with generalized anxiety disorder tend to have higher levels of intolerance for uncertainty and worry, potentially implying less willingness to change a decision once one has been made (Lee et al., 2010).”
Background
Modulation of Instagram Number of Followings by Avoidance in Close Relationships in Young Adults under a Gene x Environment Perspective
Bonassi, A., Carollo, A., Cataldo, I., Gabrieli, G., Tandiono, M., Foo, J. N., Lepri, B., & Esposito, G. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147547 · Cited by 3 · see citing works
Psychometric Properties of Persian Version of Young-Rygh Avoidance Inventory
Sefat, E. S., Sa’adati, H., Amani, S., Manijeh, H. S., & Leshni, L. (2017) · Iranian Journal of Psychiatry and Clinical Psychology · doi:10.29252/nirp.ijpcp.23.2.232 · Cited by 4 · see citing works
Putting values into words: An examination of the text characteristics of values articulation
Katz, A. M., Czech, S. J., & Orsillo, S. M. (2014) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2013.11.004 · Cited by 4 · see citing works
Self-citation
Eudaimonic Well-Being of Italian Young Adults during the COVID-19 Pandemic: The Role of Psychological Inflexibility and Fear of DeathPreprint
Calvo, V., Masaro, C., Fusco, C., et al. (2023) · Preprints.org · doi:10.20944/preprints202303.0554.v1 · Cited by 3 · see citing works
Acceptance and Commitment: An Intervention for Improving Family Function and Emotional Problems in Informal Caregivers of People with Severe Traumatic Brain Injury: A Randomized Clinical Trial.
Zanjani, Z., Hadavand, M., Omidi, A., Atoof, F., & Fakharian, E. (2022) · Archives of Trauma Research · doi:10.4103/atr.atr_4_22 · Cited by 3 · see citing works
An in-depth examination of intolerance of uncertainty and its modification in generalized anxiety disorder
Fracalanza, K. (2021) · doi:10.32920/ryerson.14657616.v1 · Cited by 4 · see citing works
The Relationship of Experiential Avoidance, Familial Emotional Atmosphere and Self-Control with Online Gaming Addiction in Bachelor Student of Shahid Chamran University of Ahvaz
Zandipayam, A., Davoudi, I., & Mehrabizadeh, M. (2017) · Journal of Education and Community Health · doi:10.21859/jech-03014 · Cited by 3 · see citing works
Relationships between Obsessive Beliefs, Experiential Avoidance, AIDS-related Knowledge/Attitude, and AIDS Phobia among Nurses
Suh, K., & 양승애 (2012) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2012.17.3.010 · Cited by 3 · see citing works
Acceptance and commitment therapy for trauma-related problems.
Engle, J. L., & Follette, V. M. (2012) · American Psychological Association eBooks · doi:10.1037/13746-017 · Cited by 3 · see citing works
The relationship between psychological resilience, cognitive emotion regulation strategies, and climate anxiety: a systematic review
Plohl, N., Lampret, A., Smrke, U., Krajnc, Ž., Kos, T., & Musil, B. (2026) · Current Psychology · doi:10.1007/s12144-025-08553-w · Cited by 5 · see citing works
Generalized anxiety disorder and social media addiction relationships: The role of psychological resilience, doomscrolling and cyberchondria severity
Kurtça, T. T. (2025) · Psihologija · doi:10.2298/psi230921004t · Cited by 2 · see citing works
Cognitive Flexibility and Emotion Regulation in Eating Disorder Patients with Comorbid Generalized Anxiety and Posttraumatic Stress SymptomsPreprint
Thompson, C. J., & Martin‐Wagar, C. A. (2024) · Research Square · doi:10.21203/rs.3.rs-4326208/v1 · Cited by 2 · see citing works
“In�exible behavior is also exhibited in GAD, where experiential avoidance (avoidance of emotions or internal experiences) is much more prevalent than in non-clinical groups (Lee et al., 2010).”
Background
Eudaimonic Well-Being of Italian Young Adults during the COVID-19 Pandemic: Predictive and Mediating Roles of Fear of Death and Psychological Inflexibility
Calvo, V., Masaro, C., Fusco, C., Pellicelli, C., Ghedin, S., & Marogna, C. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20115960 · Cited by 3 · see citing works
“Furthermore, research has highlighted the interplay between experiential avoidance, anxiety, and fear, showing that individuals who often employ experiential avoidance are more at risk for developing anxiety disorders [74], experiencing fear of intense emotions, and endorsing more frequent worry [87].”
Background
Modulation of Instagram Number of Followings by Avoidance in Close Relationships in Young Adults Under a Gene x Environment PerspectivePreprint
Bonassi, A., Carollo, A., Cataldo, I., et al. (2021) · doi:10.31234/osf.io/xqr5v · Cited by 2 · see citing works
Beliefs, traits, and motivations underlying rumination
Borders, A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-812545-8.00008-5 · Cited by 2 · see citing works
Distinct Negative Beliefs About Uncertainty and Their Association With Worry: An Exploration of the Factors of the Intolerance of Uncertainty Scale and Their Correlates
Sexton, K. A. (2011) · Spectrum Research Repository (Concordia University) · Cited by 1 · see citing works
Perceived control and long-term depression and anxiety: An 18-year longitudinal mediation study of coping
Liu, Y., & Zainal, N. H. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121543 · Cited by 1 · see citing works
“The helplessness and limited personal agency arising from perceived constraint aligned closely with key correlates of GAD, including intolerance of uncertainty and threat-oriented cognitive processing (Lee et al., 2010).”
Intolerance of uncertainty dimensions and alcohol problems: The effects of coping motives and heavy drinking
Wahesh, E., & Ondrejack, L. (2024) · Journal of Addictions & Offender Counseling · doi:10.1002/jaoc.12145 · Cited by 1 · see citing works
Associates of Distress Tolerance among Adolescents: Role of Anger, Worry and Sadness
Unbrin, A., Khanum, S., Shahzadi, M., & Imtiaz, M. (2024) · Pakistan Journal of Humanities and Social Sciences · doi:10.52131/pjhss.2024.v12i1.1946 · Cited by 1 · see citing works
“Even if a number of anxiety disorders are probably exacerbated by an intolerance for uncertainty (Lee, Orsillo, Roemer, & Allen, 2010).”
Background
The impact of reduced worry on general functioning: A mediation analysis from a randomized trial
Andersson, E., Mataix‐Cols, D., Lauri, K. O., de Schipper, E. J., Ljótsson, B., Aspvall, K., & Wahlund, T. (2023) · Stress and Health · doi:10.1002/smi.3319 · Cited by 1 · see citing works
THE ROLE OF SELF-EFFICACY IN THE RELATIONSHIP BETWEEN EXPERIENTIAL AVOIDANCE AND ANXIETY
Michel, R. (2022) · doi:10.23860/thesis-michel-rebecca-2022 · Cited by 1 · see citing works
Att leva med en världsomfattande pandemi
Jukkala, T., Ферландер, С., Aytar, O., Engdahl, E., Hristova, A., Hopstadius, M., Blasko, A. M., & Misheva, V. (2021) · Sociologisk Forskning · doi:10.37062/sf.58.22256 · Cited by 1 · see citing works
Attentional and Emotional Consequences of Emotional Acceptance and Suppression in an Elevated Anxiety Sample
Arbid, N. (2017) · Cited by 1 · see citing works
Do treatment responders maintain their gains following a randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder?
Hayes-Skelton, S. A., Roemer, L., & Orsillo, S. M. (2025) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2024.2417423
Self-citation

Fear of Emotions, Experiential Avoidance, and Intolerance of Uncertainty in Worry and Generalized Anxiety Disorder
Buhr, K., & Dugas, M. J. (2012) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2012.5.1.1 · Cited by 65 · see citing works
Expanding our conceptualization of excessive worry and GAD : the role of fear and avoidance of emotional experiences
Buhr, K. (2007) · Spectrum Research Repository (Concordia University) · Cited by 1 · see citing works
Fear and avoidance of internal experiences in GAD: Preliminary tests of a conceptual model
Roemer, L., Salters, K., Raffa, S. D., & Orsillo, S. M. (2005) · Cognitive Therapy and Research · doi:10.1007/s10608-005-1650-2 · Cited by 344 · see citing works
Self-citation
Generalized anxiety disorder. Diagnostics and treatment
Naumann, L., & Gerlach, A. L. (2014) · Kölner Universitäts PublikationsServer (Universität zu Köln)
A novel theory of experiential avoidance in generalized anxiety disorder: A review and synthesis of research supporting a contrast avoidance model of worry
Newman, M. G., & Llera, S. J. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.01.008 · Cited by 598 · see citing works

Authors: Lee, J. K., Orsillo, S. M., Roemer, L., & Allen, L. B.
Affiliations: Suffolk University (US)
University of Massachusetts Boston (US)
University of California, Los Angeles (US)
Corresponding author: Lee, Jonathan K.
ORCID: Lee, Jonathan K.
Orsillo, Susan M.
Roemer, Lizabeth
Venue: Cognitive Behaviour Therapy
Publisher: Informa UK Limited
Published: 2009-08-27
Volume: 39
Issue: 2
Pages: 126-136
ISSN: 1650-6073 (ISSN-L)
1651-2316
DOI: 10.1080/16506070902966918
PMC: PMC2866754
OpenAlex: W2032651505
Cited by: 124
References: 50
Citations by year: 2026: 5 · 2025: 5 · 2024: 13 · 2023: 5 · 2022: 7 · 2021: 13 · 2020: 8 · 2019: 5 · 2018: 10 · 2017: 12 · 2016: 5 · 2015: 4 · 2014: 11 · 2013: 6 · 2012: 4
FWCI: 6.34
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Cognitive Behaviour Therapy (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (MH63208, R21MH063208)
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 › Psychotherapy Techniques and Applications
Keywords: generalized anxiety disorder, experiential avoidance, intolerance of uncertainty, worry, positive emotions, negative affect, treatment-seeking patients
MeSH terms: Adult, Affect, Aged, Anxiety Disorders, Boston, Defense Mechanisms, Female, Humans, Male, Middle Aged, Sex Factors, Uncertainty

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Distress and avoidance in generalized anxiety disorder: Exploring the relationships with intolerance of uncertainty and worry

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