Approach and avoidance tendencies in depression and anxiety disorders

• Published in: Psychiatry research 2017-10, Vol.256, p.475-481
• Main Authors: Struijs, Sascha Y., Lamers, Femke, Vroling, Maartje S., Roelofs, Karin, Spinhoven, Philip, Penninx, Brenda W.J.H.
• Format: Article
• Language: English
• Subjects: AAT; Activation; Adult; Anxiety Disorders - psychology; Automatic; Behavior; Depressive Disorder - psychology; Facial Expression; Female; Humans; Inhibition; Inhibition (Psychology); Interpersonal Relations; Male; Middle Aged; Motivation; Self Report
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2017.07.010

Anxiety is linked to increased avoidance and inhibition, whereas depression is linked to decreased approach and diminished behavioral activation. Although these notions are widely recognized, systematic investigation of approach-avoidance tendencies is lacking across these diagnostic groups. Participants (mean age = 45.6; 65.8% female) were subdivided in healthy controls (405), remitted patients (877) and currently anxious (217), depressed (154) or comorbid (154) patients. Automatic approach-avoidance tendencies in reaction to facial expression were assessed using the Approach-Avoidance-Task (AAT). Self-reported trait approach and avoidance tendencies were assessed using the BIS/BAS scale. Severity of psychopathology was assessed to examine dose-response relationships. We did not find any consistent associations of automatic approach-avoidance tendencies with psychiatric variables. In contrast, medium to large differences in BIS scores showed increased trait avoidance tendencies in all patient groups relative to healthy controls. Overall, it seems that increased trait avoidance, rather than decreased approach, is a characteristic of affective disorders. This holds for both depressed and anxious patients and more strongly so in severe and chronic patients. It underlines the importance to address trait avoidance tendencies in the treatment of affective disorders. •Automatic and trait approach-avoidance behavior was assessed in depressed and anxious patients.•Overall, we found no consistent associations of automatic approach-avoidance behavior with psychiatric variables.•Trait avoidance was stronger in all patient groups compared to healthy controls.