(PS7-C68) Dimensions of Experiential Avoidance in Obsessive-compulsive Disorder

Experiential avoidance (EA) is a construct that captures attempts to avoid distress across cognitive, behavioral, and emotional domains. EA is multidimensional, including facets such as overt behavioral avoidance, nonacceptance of distress, negative attitudes towards distress, and attempts to mitigate distress through distraction, delay or suppression. Greater levels of EA are associated with affective disorders, including obsessive-compulsive disorder (OCD). One key limitation of the extant research on EA and OCD is that all available studies have relied on the Acceptance and Action Questionnaire-II (AAQ-II) to assess EA. The AAQ-II has poor discriminant validity with neuroticism and negative affect, which makes it unclear whether the associations noted in relation to OCD are specific. An additional critique of the AAQ-II is that it only captures two facets of EA and does not measure additional domains of EA that could be relevant to psychopathology from an etiological and treatment perspective. The current study aimed to examine the relationship between OCD symptoms and EA using a multidimensional measure of EA, taking into account theoretically relevant covariates.

One hundred five young adults (mean age = 18.97, 56.2% female) were recruited from the University of Miami and completed a battery of questionnaires. OCD symptoms were assessed using the Dimensional Obsessive-Compulsive Scale (DOCS), which assesses four domains: contamination, responsibility for harm, unacceptable thoughts, and symmetry. EA was assessed with the Multidimensional Experiential Avoidance Questionnaire (MEAQ), which includes 6 subscales: overt behavioral avoidance, distress aversion that captures nonacceptance of distress, procrastination related to delaying anticipated distress, distraction & suppression which includes attempts to ignore or suppress distress, the tendency to rely on repression & denial to distance and dissociate from distress, and distress endurance which includes negative attitudes about experiencing distress. The Patient Health Questionnaire-9 and the General Anxiety Disorder-7 were included to capture depression and anxiety symptoms as two theoretically relevant covariates. Each of the MEAQ subscales and the two covariates were regressed simultaneously on each of the DOCS subscales to examine unique associations between different facets of EA and OCD symptom domains.

Concerns about harm were associated with MEAQ Behavioral Avoidance (ß = .24, t = 2.10, p = .038) and MEAQ Repression & Denial (ß = .32, t = 3.12, p = .002). Unacceptable thoughts were associated with MEAQ Distress Aversion (ß = .21, t = 2.02, p = .046) and MEAQ Repression & Denial (ß = .19, t = 2.00, p = .048). Symmetry was associated with MEAQ Repression & Denial (ß = .19, t = 3.43, p < .001). Contamination was not significantly associated with any of the predictors. These findings suggest that the Repression & Denial facet of EA, in particular, may play a critical role in OCD. Future work in clinical samples is warranted, but our work suggests that treatment efforts aimed at reducing EA in OCD patients should perhaps be more specifically targeted on this facet. Data collection is ongoing, and we anticipate a larger sample size by the time the poster is presented.