Boelen Paul A, Eisma Maarten C
a Department of Clinical and Health Psychology , Utrecht University , Post Box 80140, 3508 TC Utrecht , the Netherlands.
Anxiety Stress Coping. 2015;28(5):587-600. doi: 10.1080/10615806.2015.1004054. Epub 2015 Feb 4.
Avoidance behavior is a central component of cognitive behavioral theories of bereavement-related psychopathology. Yet, its role is still not well understood. This study examined associations of anxious and depressive avoidance behaviors with concurrently and prospectively assessed symptom-levels of prolonged grief disorder (PGD), depression, and posttraumatic stress disorder (PTSD).
Two hundred and ninety-one individuals, confronted with loss maximally three years earlier, completed self-report measures of anxious and depressive avoidance and emotional distress and again completed distress measures one year later.
Anxious and depressive avoidance were concurrently associated with symptom-levels of PGD, depression, and PTSD, even when controlling for the shared variance between both forms of avoidance and relevant socio-demographic and loss-related variables. Prospective analyses showed that baseline anxious avoidance predicted increased symptom-levels of PGD, depression, and PTSD one year later, among participants who were in their first year of bereavement but not among those who were beyond this first year. Baseline depressive avoidance was significantly associated with elevated PTSD one year later, irrespective of time since loss.
Both anxious and depressive avoidance are associated with different indices of poor long-term adjustment following loss. However, anxious avoidance seems primarily detrimental in the first year of bereavement.
回避行为是丧亲相关精神病理学认知行为理论的核心组成部分。然而，其作用仍未得到充分理解。本研究考察了焦虑和抑郁性回避行为与同时期及前瞻性评估的持续性悲伤障碍（PGD）、抑郁症和创伤后应激障碍（PTSD）症状水平之间的关联。
291名在最多三年前经历过丧亲之痛的个体完成了焦虑和抑郁性回避以及情绪困扰的自我报告测量，并在一年后再次完成了困扰测量。
即使在控制了两种形式的回避行为以及相关社会人口统计学和丧亲相关变量之间的共同方差后，焦虑和抑郁性回避仍与PGD、抑郁症和PTSD的症状水平同时相关。前瞻性分析表明，在处于丧亲第一年的参与者中，基线焦虑性回避可预测一年后PGD、抑郁症和PTSD症状水平的增加，但在丧亲第一年之后的参与者中则不然。基线抑郁性回避与一年后PTSD症状的升高显著相关，与丧亲时间无关。
焦虑和抑郁性回避均与丧亲后长期适应不良的不同指标相关。然而，焦虑性回避似乎在丧亲的第一年最为有害。
