Does experiential avoidance mediate the effects of maladaptive coping styles on psychopathology and mental health?

Fledderus, Martine; Bohlmeijer, Ernst T.; Pieterse, Marcel E.

doi:10.1177/0145445510378379

Cited by 123Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMindfulness and Compassion InterventionsPsychotherapy Techniques and Applications

Does experiential avoidance mediate the effects of maladaptive coping styles on psychopathology and mental health?

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Fledderus, Martine, Bohlmeijer, Ernst T., Pieterse, Marcel E.·2010·Behavior Modification

DOI 10.1177/0145445510378379

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Abstract

Experiential avoidance (EA) is considered a risk factor for psychopathology.This study explores whether EA mediates the relationship between maladaptive coping styles (palliative, avoidance, and passive coping) and psychopathology and positive mental health. A total of 93 adults with mild to moderate psychological distress completed measures assessing coping styles, psychopathology (depression, anxiety, and alcohol use), and mental health (emotional, psychological, and social well-being). Results showed that EA mediated the effects of passive coping on both increased anxiety and depression and decreased emotional and psychological well-being. These results suggest that a person who is prone to use EA or has learned EA in stressful situations has a higher risk of developing psychopathology and lower mental health.This indicates that early interventions that aim at people with high levels of EA are highly relevant.

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Some processes targeted by acceptance and commitment therapy, such as experiential avoidance, cognitive fusion, or self-as-content, seem to be associated with the development and maintenance of psychopathologies and psychological alterations in normative and clinical or chronic pain populations.
“Some of these processes, such as experiential avoidance, cognitive fusion, or self-as-content seem to be associated with the development and maintenance of psychopathologies and the psychological alterations both in normative [77,78] and clinical or chronic pain populations [79,80,81,82].”
From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [78]
The Discussion (page unavailable) links experiential avoidance to depressive symptoms, anxiety, and reduced well-being. The Method Participants section (page unavailable) describes adults with mild to moderate anxiety or depressive symptoms, not a general normative or chronic-pain sample; the cited findings do not address cognitive fusion or self-as-content. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Mindfulness and experiential avoidance have been examined as personal dispositions that vary across individuals.
“In addition to their utility as psychotherapeutic targets, mindfulness and experiential avoidance have been examined as personal dispositions that vary across individuals [31, 37-39]”
From Mindfulness, Experiential Avoidance, and Recovery From Hematopoietic Stem Cell Transplantation. (2019) · cites this paper as [31]
The Measures section treats experiential avoidance as an individual-level variable, using the AAQ-II to score participants on it. The paper discusses mindfulness as part of therapy in the Discussion, but does not examine mindfulness as a disposition varying across individuals. (LLM, conf=0.86)
Experimental — accuracy not yet measured
The attempt to avoid or suppress difficult thoughts can conversely increase those thoughts and the accompanying emotions.
“In fact, the attempt to avoid or suppress difficult thoughts can conversely increase those thoughts and the accompanying emotions [28-31]”
From Mindfulness, Experiential Avoidance, and Recovery From Hematopoietic Stem Cell Transplantation. (2019) · cites this paper as [31]

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“It is also in line with literature that have linked EA with the development and persistence of psychological distress (Hayes et al., 2004) and higher risk of developing psychopathology (Fledderus et al., 2010).”
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“These constructs are usually combined (Hayes et al., 1996), and research has demonstrated that maladaptive coping styles, particularly avoidance, may be associated with poor outcomes (Fledderus et al., 2010).”
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“Prior studies identified various risk factors for experiential avoidance, such as mal-adaptive coping styles (Fledderus et al., 2010), trauma symptoms (Franz et al., 2021), gender role conflict (Spendelow & Joubert, 2018), and anxiety sensitivity (Ugwu et al., 2021).”
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“Indeed, avoidance is a fundamental process in many forms of high-risk psychopathology (Chawla & Ostafin, 2007; Fledderus, Bohlmeijer, & Pieterse, 2010).”
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“When feeling worried or distressed, individuals who use experiential avoidance and maladaptive coping show decreased emotional and psychological well-being (Fledderus et al., 2010).”
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Juszczyk-Kalina, A., Holas, P., Bachem, R., & Roczon, P. (2026) · Journal of American College Health · doi:10.1080/07448481.2025.2593313 · Cited by 2 · see citing works
“Additionally, Fledderus et al. 69 demonstrated that individuals prone to using experiential avoidance in stressful situations face an elevated risk of developing psychopathology.”
Emotion Regulation Under Stress: A Social Processing and Memory Perspective
Dennis, N. J., Bulgin, T., Nicastri, C. M., Bell, C., & Delgado, M. R. (2024) · Current topics in behavioral neurosciences · doi:10.1007/7854_2024_560 · Cited by 2 · see citing works
“Similar to suppression, experiential avoidance tends to increase negative affect; however, individuals continue to use experiential avoidance as an emotion regulation strategy due to its seemingly positive outcomes, even if short-term (Sloan 2004; Fledderus et al. 2010).”
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“Furthermore, experiential avoidance has been reported to hinder the pursuit of actions aligned with personal values (Fledderus et al., 2010), indicating that it can obstruct taking steps toward what is important in life.”
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Authors: Fledderus, M., Bohlmeijer, E. T., & Pieterse, M. E.
Affiliations: University of Twente (NL)
Corresponding author: Fledderus, Martine
ORCID: Bohlmeijer, Ernst T.
Pieterse, Marcel E.
Venue: Behavior Modification
Publisher: SAGE Publications
Published: 2010-07-21
Volume: 34
Issue: 6
Pages: 503-519
ISSN: 0145-4455 (ISSN-L)
1552-4167
DOI: 10.1177/0145445510378379
OpenAlex: W2127511991
Cited by: 123
References: 37
Citations by year: 2026: 1 · 2025: 3 · 2024: 10 · 2023: 8 · 2022: 10 · 2021: 13 · 2020: 11 · 2019: 8 · 2018: 5 · 2017: 7 · 2016: 9 · 2015: 7 · 2014: 11 · 2013: 4 · 2012: 10
FWCI: 7.91
Type: journal article
Language: en
Open access: green
research.utwente.nl
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Behavior Modification (publishedVersion)
PubMed (publishedVersion)
University of Twente Research Information (submittedVersion)
University of Twente Research Information (submittedVersion, other-oa)
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: experiential avoidance, passive coping, avoidance coping, palliative coping, psychopathology, depression, anxiety, alcohol consumption, well-being, mediation, psychological distress
MeSH terms: Adaptation, Psychological, Adult, Aged, Alcoholism, Anxiety, Depression, Emotions, Female, Humans, Male, Mental Health, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Risk Factors, Stress, Psychological

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Does experiential avoidance mediate the effects of maladaptive coping styles on psychopathology and mental health?

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