Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-23T10:47:03.889Z Has data issue: false hasContentIssue false
  • English
  • Français

Avoidance in Anxiety and Depression: Adaptation of the Cognitive-Behavioral Avoidance Scale in a Spanish Sample

Published online by Cambridge University Press:  22 February 2017

Santiago Barajas Open the ORCID record for Santiago Barajas [Opens in a new window] ,
Luis Garra  and
Laura Ros
Santiago Barajas*
Affiliation:
Hospital Universitario de Guadalajara (Spain)
Luis Garra
Affiliation:
Universidad de Castilla La Mancha (Spain)
Laura Ros
Affiliation:
Universidad de Castilla La Mancha (Spain)
*
*Correspondence concerning this article should be addressed to Santiago Barajas. Hospital Universitario de Guadalajara. C/ Donante de Sangre s/n. 19002. Guadalajara (Spain). E-mail: sbarajas@sescam.jccm.es
Get access Rights & Permissions [Opens in a new window]

Abstract

This study examines how cognitive, behavioral and experiential avoidance differs between clinical patients (N = 100), the general population (N = 100), and undergraduate students (N = 54). For this purpose, a Spanish adaptation of the Cognitive-Behavioral Avoidance Scale (CBAS; Ottenbreit & Dobson, 2004) was made. Confirmatory factor analysis supports the four factors structure similar to the original one, yet question the value of three of the items (CFI = .929, RMSEA = .057, SRMR = .051, χ2(333) = 603.28, p < .001, χ2/df = 1.81). Effect sizes calculated using Cohen’s ƒ2 were between 0.30 and 2.57 in all cases, and only one item showed value < 0.35. The internal consistency for the total scale was .95, and adequate alpha values for the four subscales were found (α between .74 and .93). Statistical differences were found between the clinical and non-clinical groups, and also between the clinical and undergraduate groups (GLM, p < .001). The validity was verified using correlations with AAQ-II, MAAS, BDI-II and BAI. There is a correlation between cognitive-behavioral avoidance and experiential avoidance in both the clinical and control groups (rho = .382, rho = .361, p < .01). Patients with higher levels of cognitive-behavioral avoidance have higher levels of depression (rho = .36, p < .01). A score of 53 is suggested as the optimum cut-off point, because at this point, sensitivity and specificity are both 86%. The results suggest that cognitive-behavioral avoidance represents a significant factor in psychopathology. Recommendations for future studies are discussed.

Keywords

anxietyCBAScognitive-behavioral avoidancedepressionscale adaptation
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 20 , 2017 , E18
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders. (4th Ed., Text Rev.). Washington, DC: Author.Google Scholar
Barajas, S. (2015). Evitación y psicopatología: Un estudio a través de una tarea experimental y su relación con medidas de autoinforme. [Avoidance and psychopathology: A study through an experimental task and its relation with self-report measures]. Revista de Psicopatología y Psicología Clínica, 20, 63–73. http://doi.org/10.5944/rppc.vol.1.num.1.2015.14409 Google Scholar
Barajas, S., & Garra, L. (2014). Mindfulness and psychopathology: Adaptation of the Mindful Attention Awareness Scale (MAAS) in a Spanish sample. Clínica y Salud, 25, 49–56. http://doi.org/10.1016/S1130-5274(14)70026-X Google Scholar
Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic. (2nd Ed.). New York, NY: Guilford Press.Google Scholar
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI-II. Beck Depression Inventory-Second Edition. Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory. Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Bentler, P. M. (1992). On the fit of models to covariances and methodology to the bulletin. Psychological Bulletin, 112, 400–404. http://doi.org/10.1037/0033-2909.112.3.400 Google Scholar
Blalock, J. A., & Joiner, T. E Jr. (2000). Interaction of cognitive avoidance coping and stress in predicting depression/anxiety. Cognitive Therapy and Research, 24, 47–65. http://doi.org/10.1023/A:1005450908245 Google Scholar
Bollen, K. A., & Stine, R. A. (1992). Bootstrapping goodness of fit measures in structural equation models. Sociological Methods and Research, 21, 205–229. http://doi.org/10.1177/0049124192021002004 Google Scholar
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., … Zettle, R. D. (2011). Preliminary psychometric properties of Acceptance and Action Questionnaire-II. A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42, 676–688. http://doi.org/10.1016/j.beth.2011.03.007 Google Scholar
Bordieri, M. J., Tull, M. T., McDermott, M. J., & Gratz, K. L. (2014). The moderating role of experiential avoidance in the relationship between posttraumatic stress disorder symptom severity and cannabis dependence. Journal of Contextual Behavioral Science, 3, 273–278. http://doi.org/10.1016/j.jcbs.2014.08.005 Google Scholar
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848. http://doi.org/10.1037/0022-3514.84.4.822 Google Scholar
Browne, M. W., & Cudek, R. (1993). Alternative ways of assessing model fit. In Bollen, K. A. & Long, J. S. (Eds.), Testing structural models (pp. 136–162). Newbury Park, CA: Sage.Google Scholar
Byrne, B. M. (2010). Structural equation modeling AMOS: Basic concepts, applications, and programming. New York, NY: Taylor & Francis.Google Scholar
Byrne, B. M., & Campbell, T. L. (1999). Cross-cultural comparisons and the presumption of equivalent measurement and theoretical structure: A look beneath the surface. Journal of Cross-Cultural Psychology, 30, 555–574. http://doi.org/10.1177/0022022199030005001 Google Scholar
Carvalho, J. P., & Hopko, D. R. (2011). Behavioral therapy of depression: Reinforcement as a mediating variable between avoidance and depression. Journal of Behavior Therapy and Experimental Psychiatry, 42, 154–162. http://doi.org/10.1016/j.jbtep.2010.10.001 Google Scholar
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. http://doi.org/10.1037/0033-2909.112.1.155 Google Scholar
Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28, 857–870. http://doi.org/10.1037/h0035605 Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (1999). Entrevista clínica estructurada para los trastornos del eje I del DSM-IV. Versión clínica. [Structured clinical interview for DSM-IV axis I disorders: Clinical version]. Barcelona, Spain: Masson.Google Scholar
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44, 1–25. http://doi.org/10.1016/j.brat.2005.06.006 Google Scholar
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimension approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152–1168. http://doi.org/10.1037/0022-006X.64.6.1152 Google Scholar
Hernández-Guzmán, L., Dobson, K. S., Caso-Niebla, J., Gónzalez-Montesinos, M., Epp, A., Arratíbel-Siles, M. L., & Wierzbicka-Szymczak, E. (2009). La versión en español de la Escala Cognitivo-Conductual de Evitación [The Spanish version of the Cognitive-Behavioral Avoidance Scale]. Revista Latinoamericana de Psicología, 41, 99–108.Google Scholar
Hu, L.-t., & Bentler, P. M. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55. http://doi.org/10.1080/10705519909540118 Google Scholar
Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8, 225–270. http://doi.org/10.1093/clipsy.8.3.255 Google Scholar
Kashdan, T. B., Barrios, V., Forsyth, J. P., & Steger, M. F. (2006). Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behaviour Research and Therapy, 44, 1301–1320. http://doi.org/10.1016/j.brat.2005.10.003 Google Scholar
Levitt, J. T., Brown, T. A., Orsillo, S. M., & Barlow, D. H. (2004). The effects of acceptance versus suppression of emotion on subjective and psychophysiological response to carbon dioxide challenge in patients with panic disorder. Behavior Therapy, 35, 747–766. http://doi.org/10.1016/S0005-7894(04)80018-2 CrossRefGoogle Scholar
Moulds, M. E., Kandris, E., Starr, S., & Wong, A. C. M. (2007). The relationship between rumination, avoidance and depression in a non-clinical sample. Behaviour Research and Therapy, 45, 251–261. http://doi.org/10.1016/j.brat.2006.03.003 CrossRefGoogle Scholar
Muñiz, J., & Hambleton, R. K. (1996). Directrices para la traducción y adaptación de los tests. [Guidelines for test translation and adaptation]. Papeles del Psicólogo, 66, 63–70.Google Scholar
Ottenbreit, N. D., & Dobson, K. S. (2004). Avoidance and depression: The construction of the Cognitive-Behavioral Avoidance Scale. Behaviour Research and Therapy, 42, 292–313. http://doi.org/10.1016/S0005-7967(03)00140-2 Google Scholar
Ottenbreit, N. D., Dobson, K. S., & Quigley, L. (2014). An examination of avoidance in major depression in comparison to social anxiety disorder. Behaviour Research and Therapy, 56, 82–90. http://doi.org/10.1016/j.brat.2014.03.005 Google Scholar
Röthlin, P., Holtforth, M. G., Bergomi, C., Berking, M., Ottenbreit, N. D., & Caspar, F. (2010). Vermeidung und depression: Die psychometrische evaluation der deutschen version der Cognitive-Behavioral Avoidance Scale (CBAS). [Avoidance and depression: The psychometric evaluation of the German version of the “Cognitive-Behavioral Avoidance Scale” (CBAS)]. Diagnostica, 56, 46–55. http://doi.org/10.1026/0012-1924/a000008 Google Scholar
Ruiz, F. J., Langer Herrera, A. I., Luciano, C., Cangas, A. J., & Beltrán, I. (2013). Measuring experiential avoidance and psychological inflexibility: The Spanish version of the Acceptance and Action Questionnaire-II. Psicothema, 25, 123–129. http://doi.org/10.7334/psicothema2011.239 Google Scholar
Sanz, J., & Navarro, M. E. (2003). Propiedades psicométricas de una versión española del Inventario de Ansiedad de Beck (BAI) en estudiantes universitarios. [Psychometric properties of a Spanish version of the Beck Anxiety Inventory (BAI) with university students]. Ansiedad y Estrés, 9, 59–84.Google Scholar
Sanz, J., Navarro, M. E., & Vázquez, C. (2003). Adaptación española del Inventario para la Depresión de Beck-II (BDI-II): Propiedades psicométricas en estudiantes universitarios. [Spanish adaptation of the Beck Depression Inventory-II (BDI-II): Psychometric properties with university students]. Análisis y Modificación de Conducta, 29, 239–288.Google Scholar
Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th Ed.). Needham Heights, MA: Allyn & Bacon.Google Scholar
Vilardaga, R., Hayes, S. C., Atkins, D. C., Bresee, C., & Kambiz, A. (2013). Comparing experiential acceptance and cognitive reappraisal as predictors of functional outcome in individuals with serious mental illness. Behaviour Research and Therapy, 51, 425–433. http://doi.org/10.1016/j.brat.2013.04.003 Google Scholar