Experiential avoidance is a predictor for major depressive disorder and generalized anxiety disorder symptomatology in older adolescents, data from an observational, longitudinal study published in the Journal of Clinical Psychiatry suggest.
“An intervention targeting [experiential avoidance (EA)] in adolescents may lead to valuable outcomes,” the researchers wrote. “Acceptance and commitment therapy (ACT) is a behavioral intervention that aims to help patients overcome EA with acceptance, mindfulness and behavioral change strategies.”
Researchers examined 183 adolescents aged 15 to 20 years for 2 years via a comprehensive assessment battery, with DSM-IV-TR used to diagnose major depressive disorder (MDD) and generalized anxiety disorder (GAD). Data were collected from September 2010 to April 2016. Participants were split into four MDD and GAD trajectory groups based on symptom prevalence, with 81 participants classified as persistent, 44 as high-decreasing, 37 as normal-increasing and 21 as minimal. EA was evaluated on a seven-point Likert scale.
All selected participants did not significantly differ from those with partial EA data in regards to sex, age, ethnicity, anxiety symptoms, depressive symptoms or EA. However, participants differed from those with partial EA data in regard to race (P .001).
Participants in the persistent group showed higher EA than other groups (P .001), with EA successfully predicting both anxiety and depression symptoms (P .005). Additionally, adolescents in the persistent group showed greater EA stability compared with adolescents in the decreasing group (P = .008). EA also predicted combined GAD and MDD trajectories after adjustment for confounders such as depressive and anxiety symptoms (P = < .001).
“ACT treatment trials in adults have shown that decreases in EA are associated with depressive and anxiety symptom reduction,” the researchers wrote. “Future studies should examine whether changes in EA among adolescents mediate treatment outcomes in depressive and anxiety symptoms.” – by Eamon Dresibach
Disclosures: The authors report funding from the NIMH, the National Center for Research Resources and the Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center.