Experiential Avoidance Predicts Persistence of Major Depressive Disorder and Generalized Anxiety Disorder in Late Adolescence

William H Mellick; James A Mills; Emily B Kroska; Chadi A Calarge; Carla Sharp; Lilian N Dindo

doi:10.4088/JCP.18m12265

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Experiential Avoidance Predicts Persistence of Major Depressive Disorder and Generalized Anxiety Disorder in Late Adolescence

Journal article

Peer reviewed

Experiential Avoidance Predicts Persistence of Major Depressive Disorder and Generalized Anxiety Disorder in Late Adolescence

William H Mellick, James A Mills, Emily B Kroska, Chadi A Calarge, Carla Sharp and Lilian N Dindo

The journal of clinical psychiatry, Vol.80(6), 18m12265

10/22/2019

DOI: 10.4088/JCP.18m12265

PMCID: PMC6854672

PMID: 31644841

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https://www.ncbi.nlm.nih.gov/pmc/articles/6854672View

Open Access

Abstract

Experiential avoidance (EA) is a transdiagnostic construct that may underlie the high comorbidity between major depressive disorder (MDD) and generalized anxiety disorder (GAD). This analysis used data from a longitudinal study (conducted September 2010-April 2016) to examine whether adolescent EA varies by MDD and GAD symptomatology trajectory and predicts said trajectories. Longitudinal associations between EA, anxiety, and depression symptoms were also examined. Adolescents aged 15 to 20 years (N = 183) were followed for 2 years using a comprehensive assessment battery. Symptom trajectory modeling, using weekly symptom ratings, identified 4 MDD and 4 GAD trajectories that were collapsed to form combined MDD/GAD trajectory groups: Persistent (n = 81), High-Decreasing (n = 44), Normal-Increasing (n = 37), and Minimal (n = 21). Group-based trajectory modeling, analyses of covariance, structural equation modeling, and linear regression analyses were performed. DSM-IV-TR criteria were used for MDD and GAD diagnoses. The Persistent adolescents had higher EA than other groups (P values ≤ .001), with greater EA stability versus High-Decreasing adolescents (P = .008). EA predicted anxiety and depressive symptoms alike (P values ≤ .005), which in turn did not predict EA (P values ≥ .188). EA, at both time points, predicted combined MDD/GAD trajectories after adjustment for depressive and anxiety symptoms and other confounders (P values < .001). EA appears to be an important predictor of MDD and GAD symptomatology in older adolescents, potentially serving as a treatment target. Findings suggest a possible trait-like nature for EA, perhaps increasing risk for the emergence and persistence of MDD and/or GAD. ClinicalTrials.gov identifier: NCT02147184.

Comorbidity

Acceptance and Commitment Therapy

Adolescent

Anxiety Disorders - diagnosis

Anxiety Disorders - drug therapy

Anxiety Disorders - psychology

Avoidance Learning

Chronic Disease

Correlation of Data

Depressive Disorder, Major - diagnosis

Depressive Disorder, Major - drug therapy

Depressive Disorder, Major - psychology

Female

Humans

Longitudinal Studies

Male

Problem-Based Learning

Risk Factors

Serotonin Uptake Inhibitors - therapeutic use

Surveys and Questionnaires

Young Adult

Details

Title: Subtitle: Experiential Avoidance Predicts Persistence of Major Depressive Disorder and Generalized Anxiety Disorder in Late Adolescence
Creators: William H Mellick - Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
James A Mills - Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA
Emily B Kroska - Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
Chadi A Calarge - Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
Carla Sharp - Department of Psychology, University of Houston, Houston, Texas, USA
Lilian N Dindo - Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
Resource Type: Journal article
Publication Details: The journal of clinical psychiatry, Vol.80(6), 18m12265
DOI: 10.4088/JCP.18m12265
PMID: 31644841
PMCID: PMC6854672
NLM abbreviation: J Clin Psychiatry
ISSN: 0160-6689
eISSN: 1555-2101
Grant note: F32 AA027136 / NIAAA NIH HHS
Language: English
Date published: 10/22/2019
Academic Unit: Psychiatry; Psychological and Brain Sciences
Record Identifier: 9984214749002771

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