Department of Psychology, University of Iowa, IA, USA.
Anxiety Stress Coping. 2010 Jan;23(1):87-99. doi: 10.1080/10615800802699198.
Both distress and behavioral avoidance have been implicated in the development and maintenance of many forms of psychopathology. However, it is still unclear whether these constructs can be distinguished, or whether both can independently explain comorbid psychopathology (CP) as they are normally assessed (via self-report methods). To help address these questions, we assessed distress and avoidance in relation to phobic situations via structured interview in a sample of college students (N=385) and a sample of psychiatric outpatients (N=288). Various types of psychopathology were also assessed. Structural equation modeling revealed that individuals do not readily distinguish between distress and avoidance, and that self-reported avoidance does not predict the severity of CP after distress associated with avoided situations has been taken into account. These data suggest that situational distress and avoidance cannot be clearly distinguished in self-reported assessments and raise questions concerning the common practice of relying on client report to measure avoidance. Hence, different methods are needed to obtain clinically useful ratings of avoidance.
痛苦和行为回避都与许多形式的精神病理学的发展和维持有关。然而，目前尚不清楚这些结构是否可以区分，或者它们是否都可以独立地解释共病精神病理学（CP），因为它们通常是通过（通过自我报告方法）评估的。为了帮助解决这些问题，我们通过结构化访谈评估了大学生样本（N=385）和精神病门诊患者样本（N=288）中与恐惧症相关的痛苦和回避情况。还评估了各种类型的精神病理学。结构方程模型显示，个体不容易区分痛苦和回避，并且在考虑到与回避情况相关的痛苦之后，自我报告的回避并不能预测 CP 的严重程度。这些数据表明，在自我报告评估中，情境痛苦和回避不能清楚地区分，并对依赖于客户报告来衡量回避的常见做法提出了质疑。因此，需要使用不同的方法来获得回避的临床有用评分。
