Adult Anxiety
Evaluating the role of psychological (in)flexibility processes in explaining relations between anxiety and history of an anxiety disorder diagnosis
Max Z. Roberts, M.A.
Clinical Psychology Doctoral Student
University at Albany, State University of New York
Albany, New York
Shannon B. Underwood, B.S.
Clinical Psychology Doctoral Student
University at Albany, State University of New York
Albany, New York
Sara V. White, B.A.
Clinical Psychology Doctoral Student
University at Albany, State University of New York
Albany, New York
Eric D. Tifft, M.A.
Clinical Psychology Doctoral Candidate
University at Albany, State University of New York
Albany, New York
John P. Forsyth, Ph.D.
Professor of Psychology; Director of the Anxiety Disorders Research Program
University at Albany, State University of New York
Albany, New York
Anxiety is recognized as a ubiquitous and adaptive emotion. For some, though, anxiety is associated with enormous suffering. In line with recent process-based accounts, the psychological (in)flexibility model posits six inflexibility processes and six flexibility processes that focus on how human beings relate with and respond to anxiety and other unpleasant private events. The aim of the present study was to evaluate the unique contribution of these (in)flexibility processes in accounting for anxiety’s association with an anxiety disorder diagnosis. A community sample (N = 267; Mage = 46.4; 81% female) with any lifetime anxiety or obsessive-compulsive and related disorder (OCRD) diagnosis (n = 139) or no lifetime mental health diagnosis (n = 128) reported diagnostic history and completed a battery of measures including the Depression Anxiety and Stress Scale (DASS-21) and Multidimensional Psychological Flexibility Inventory (MPFI). Two hierarchical binary logistic regression models predicting odds of endorsing a lifetime anxiety disorder or OCRD diagnosis, or no lifetime diagnoses, were conducted entering anxiety and relevant demographics as IVs in step one, and either the six flexibility or inflexibility processes as IVs in step two. Inaction and defusion emerged as the the only significant processes in their respective models. After controlling for anxiety severity, inaction significantly predicted increased odds of having an anxiety disorder diagnosis (O.R.= 2.69; 95% C.I. [1.48, 4.88]), and defusion significantly predicted increased odds of having no diagnosis (O.R. = 1.75; 95% C.I. [1.08, 2.84]). Results showed that more inaction is associated with anxiety becoming disordered, whereas defusion may buffer against anxiety becoming disordered. Both processes denote important intervention targets and may help guide further research into the etiology and maintenance of anxiety disorders.
