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When worriers avoid their thoughts: cognitive avoidance predicts comorbid symptoms

Faculty Advisor




anxiety disorders, avoidance (psychology), comorbidity

Abstract (summary)

Previous research has shown that generalized anxiety disorder (GAD) is associated with several dysfunctional cognitive thinking styles and beliefs. While these different thinking styles and beliefs have been associated with GAD symptoms, they may also play a role in comorbid symptoms. Therefore, this study examined which dysfunctional thinking styles and beliefs common to GAD are associated with a range of emotional disorder symptoms in a group of chronic worriers. Specifically, we examined symptoms of anxiety-related disorders, depression, and bipolar disorder. A sample of undergraduate students, pre-screened for a high degree of worry (N = 565), completed online self-report measures. Questionnaires assessed symptoms of the following disorders: GAD, social anxiety disorder (SAD), panic disorder (PD), post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), health anxiety (HA), depression, and bipolar disorder. Dysfunctional thinking styles and beliefs measured include: metacognitions, intolerance of uncertainty, cognitive avoidance, negative problem orientation, fear of depression, and fear of anxiety. Although different thinking styles and beliefs were associated with each set of symptoms, regression analyses revealed that cognitive avoidance emerged as the only significant predictor across all symptom categories, with the exception of GAD. Although cognitive avoidance has been primarily explored within the GAD literature, these findings suggest that future research should also examine cognitive avoidance in SAD, PD, PTSD, OCD, HA, depression, and bipolar disorder. Additionally, when treating these disorders, or when working with anxious clients with comorbid disorders, therapists may wish to consider targeting cognitive avoidance, such as through written exposure exercises.

Publication Information



Presented on May 12-13, 2022 at the 12th Annual Canadian Association of Cognitive and Behavioural Therapies Virtual Conference held at Simon Fraser University in Vancouver, British Columbia.

Item Type

Student Presentation




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