The Role of Experiential Avoidance in the Relationship Between Maladaptive Perfectionism and Worry1
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Cognitive Therapy and Research, Vol. 30, No. 3, June 2007 (C 2006) DOI: 10.1007/s10608-006-9000-6 The Role of Experiential Avoidance in the Relationship Between Maladaptive Perfectionism and Worry1 Amanda W. Santanello2,3 and Frank L. Gardner2,4 Published online: 10 March 2006 This study examined the role of experiential avoidance in the relationship between maladaptive perfectionism and worry. The hypothesis was that experiential avoidance would mediate the relationship between maladaptive perfectionism and worry. A to- tal of 125 undergraduate participants completed measures assessing perfectionism, experiential avoidance, worry, depression, and social anxiety. A series of regression analyses showed that maladaptive perfectionism and experiential avoidance were sig- nificantly associated with worry and that experiential avoidance was a partial mediator in the relationship between maladaptive perfectionism and worry. Partial correlations revealed significant relationships between experiential avoidance and worry and be- tween one aspect of maladaptive perfectionism and worry independent of depression and social anxiety. Results suggest that experiential avoidance may be an important variable contributing to the occurrence of worry within the context of maladaptive perfectionism. KEY WORDS: experiential avoidance; perfectionism; worry; mediation. The role of experiential avoidance in various forms of psychopathology has been the subject of recent behavioral and clinical discussion (Hayes et al., 2004; Hayes, Strosahl, & Wilson, 1999; Hayes, Wilson, Gifford, Follette, & Strosahl, 1996). Experiential avoidance “is the phenomenon that occurs when a person is unwill- ing to remain in contact with particular private experiences (e.g., bodily sensa- tions, emotions, thoughts, memories, behavioral predispositions) and takes steps to alter the form or frequency of these events and the contexts that occasion them” (Hayes et al., 1996, p. 1154). In other words, experiential avoidance in- volves attempts to avoid uncomfortable internal experiences by trying to suppress or control these unpleasant private events and/or avoid the situations that produce them. 1This research was part of the first author’s dissertation. 2Department of Psychology, La Salle University, Philadelphia, Pennsylvania. 3Present address: 52 Meriam Ct., Owings Mills, Maryland, 21117. 4Correspondence should be directed to Frank L. Gardner, Department of Psychology, La Salle Univer- sity, 1900 West Olney Avenue, Philadelphia, Pennsylvania, 19141; e-mail: [email protected]. 319 0147-5916/07/0600-0319/1 C 2006 Springer Science+Business Media, Inc. 320 Santanello and Gardner Individuals often attempt to use strategies to try to control their thoughts and feelings (Hayes et al., 1996, 1999). Because avoidance strategies often briefly and im- mediately diminish unwanted internal events, individuals continue to engage in ex- periential avoidance without realizing that avoidance strategies are not effective in the long term (Hayes et al., 1996, 2004). Repeated efforts to avoid aversive thoughts or feelings often result in an increase in the thought or feeling that one intends to avoid (Gold & Wegner, 1995). Thus, control strategies may not always be effective in reducing aversive internal events. Persistent experiential avoidance can have maladaptive consequences. There are circumstances in which it is essential to experience certain difficult feelings (e.g., grief), and attempts to avoid such emotions may lead to unhealthy behaviors (e.g., substance abuse; Hayes et al., 1996, 1999). Furthermore, the initial discomfort as- sociated with change may prevent individuals from making constructive changes in their lives (Hayes et al. 1996), and the inhibition of positive behavioral actions may elicit distressful reactions and maladaptive behavior (Polivy, 1990). As men- tioned previously, attempts to control internal experiences actually may increase the targeted private events (Gold & Wegner, 1995). Overall, experiential avoidance may contribute to the development and/or maintenance of psychopathology when individuals continue to engage in efforts to control internal experiences despite un- wanted and adverse outcomes. This study focuses on the role of experiential avoidance in the relationship between two variables associated with psychopathology: maladaptive perfection- ism and worry. Significant correlations between features of maladaptive perfection- ism and worry have been established (Kawamura, Hunt, Frost, & DiBartolo, 2001; Stober¨ & Joormann, 2001). This study attempts to examine the relationship between maladaptive perfectionism and worry further by suggesting that experiential avoid- ance is a mediator in this relationship. A mediator variable is defined as “the generative mechanism through which the focal independent variable is able to influence the dependent variable of interest” (Baron & Kenny, 1986, p. 1173). In other words, it is proposed that maladaptive per- fectionism influences worry through experiential avoidance. Therefore, experiential avoidance must be related to both maladaptive perfectionism and worry. Experiential Avoidance and Maladaptive Perfectionism Recent research supports the conceptualization of perfectionism as a multidi- mensional construct. Frost, Marten, Lahart, and Rosenblate (1990) and Hewitt and Flett (1991) have examined multiple dimensions of perfectionism and developed scales to reflect their conceptualizations of perfectionism, both named the Multidi- mensional Perfectionism Scale (MPS). In a factor analysis of the Frost et al. (1990) [MPS (F-MPS)] and Hewitt and Flett (1991) [MPS (H-MPS)], two primary fac- tors emerged, which were labeled Positive Achievement Striving and Maladaptive Evaluation Concerns (Frost, Heimberg, Holt, Mattia, and Neubauer, 1993). Posi- tive Achievement Striving was associated with positive affect, and thus, may be in- terpreted to represent attributes of adaptive perfectionism. The Maladaptive Eval- uation Concerns factor was positively related to measures of negative affect and Perfectionism, Experiential Avoidance, and Worry 321 depression; therefore, it may be considered to reflect aspects of maladaptive per- fectionism. A separate confirmatory factor analysis also supported the conceptual- ization of perfectionism according to two factors, adaptive and maladaptive perfec- tionism (Bieling, Israeli, & Antony, 2004). Research studies have revealed significant relationships between maladaptive components of perfectionism and various features of psychopathology, including anger, depression, anxiety, social anxiety, obsessions and compulsions, and worry (Bieling et al., 2004; Dunkley & Blankstein, 2000; Kawamura et al., 2001;Stober¨ & Joormann, 2001). Adaptive components of perfectionism, on the other hand, were not significantly correlated with these variables. These findings suggest that maladaptive perfectionism, and not adaptive perfectionism, is associated with psy- chopathology. As both experiential avoidance and maladaptive perfectionism appear to be linked to aspects of psychopathology, it is interesting to consider a potential rela- tionship between the two. The concept of negative perfectionism, which is similar to maladaptive perfectionism, appears to be connected to avoidance in a model of per- fectionism proposed by Slade and Owens (1998). Based on reinforcement theory, the model distinguishes between positive and negative perfectionism. Positive per- fectionism is thought to be associated with positive reinforcement, whereas negative perfectionism is assumed to be related to negative reinforcement. In other words, positive perfectionism involves cognitions and behaviors that are focused on reach- ing goals and experiencing positive consequences. Thus, wanting to gain success is a motivation for positive perfectionism. In contrast, negative perfectionism involves cognitions and behaviors focused on achieving goals in order to avoid negative out- comes. Therefore, negative perfectionism appears to be motivated by a desire not to fail. Individuals with high levels of negative perfectionism would be expected to work toward the avoidance of failure and disappointment, potentially linking mal- adaptive features of perfectionism to experiential avoidance. Additional support for a relationship between maladaptive perfectionism and experiential avoidance comes from research examining perfectionism and procrasti- nation, a form of behavioral avoidance. Studies utilizing multidimensional measures of perfectionism have found that adaptive features of perfectionism are negatively correlated with procrastination and maladaptive features of perfectionism are pos- itively related to procrastination (Flett, Blankstein, Hewitt, & Koledin, 1992; Frost et al., 1990;Stober¨ & Joormann, 2001). Thus, maladaptive aspects of perfectionism are associated with avoidance of completing tasks. On the basis of the information presented earlier, a significant relationship between experiential avoidance and mal- adaptive perfectionism is proposed. Experiential Avoidance and Worry Borkovec, Alcaine, and Behar (2004) propose that worry is a cognitive process serving the function of avoidance. Worry, triggered by the perception of threat, is an effort to problem-solve or discern how to cope with negative events. Borkovec and Roemer (1995) found that individuals rated the following as two of the most common reasons that they engage in worry: preparing for potential future danger 322 Santanello and Gardner and figuring out how to avoid or