Iranian Journal of Psychiatry and Behavioral Sciences

Published by: Kowsar

The Role of Neuroticism and Experiential Avoidance in Predicting Anxiety and Depression Symptoms: Mediating Effect of Emotion Regulation

Parvaneh Mohammadkhani 1 , Imaneh Abasi 1 , * , Abbas Pourshahbaz 1 , Abolfazl Mohammadi 2 and Morteza Fatehi 3
Authors Information
1 Department of Clinical Psychology, School of Behavior Science, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
2 Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
3 Department of Psychology, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
Article information
  • Iranian Journal of Psychiatry and Behavioral Sciences: September 2016, 10 (3); e5047
  • Published Online: August 6, 2016
  • Article Type: Original Article
  • Received: December 14, 2015
  • Revised: February 8, 2016
  • Accepted: July 22, 2016
  • DOI: 10.17795/ijpbs-5047

To Cite: Mohammadkhani P, Abasi I, Pourshahbaz A, Mohammadi A, Fatehi M. The Role of Neuroticism and Experiential Avoidance in Predicting Anxiety and Depression Symptoms: Mediating Effect of Emotion Regulation, Iran J Psychiatry Behav Sci. 2016 ; 10(3):e5047. doi: 10.17795/ijpbs-5047.

Copyright © 2016, Mazandaran University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Materials and Methods
4. Results
5. Discussion
  • 1. Brown TA, Campbell LA, Lehman CL, Grisham JR, Mancill RB. Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. J Abnorm Psychol. 2001; 110(4): 585-99[PubMed]
  • 2. Hirschfeld RM. The Comorbidity of Major Depression and Anxiety Disorders: Recognition and Management in Primary Care. Prim Care Companion J Clin Psychiatry. 2001; 3(6): 244-54[PubMed]
  • 3. Hranov LG. Comorbid anxiety and depression: illumination of a controversy. Int J Psychiatry Clin Pract. 2007; 11(3): 171-89[DOI][PubMed]
  • 4. Schoevers RA, Deeg DJ, van Tilburg W, Beekman AT. Depression and generalized anxiety disorder: co-occurrence and longitudinal patterns in elderly patients. Am J Geriatr Psychiatry. 2005; 13(1): 31-9[DOI][PubMed]
  • 5. Lenze EJ, Mulsant BH, Mohlman J, Shear MK, Dew MA, Schulz R, et al. Generalized anxiety disorder in late life: lifetime course and comorbidity with major depressive disorder. Am J Geriatr Psychiatry. 2005; 13(1): 77-80[DOI][PubMed]
  • 6. Mansell W, Harvey A, Watkins E, Shafran R. Conceptual foundations of the transdiagnostic approach to CBT. J Cogn Psychother. 2009; 23(1): 6-19
  • 7. Aldao A, Nolen-Hoeksema S, Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clin Psychol Rev. 2010; 30(2): 217-37[DOI][PubMed]
  • 8. Dugas M, Robichaud M. Cognitive-behavioral treatment for generalized anxiety disorder: From science to practice. 2007;
  • 9. Gentes EL, Ruscio AM. A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder. Clin Psychol Rev. 2011; 31(6): 923-33[DOI][PubMed]
  • 10. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2006; 44(1): 1-25[DOI][PubMed]
  • 11. McLaughlin KA, Nolen-Hoeksema S. Rumination as a transdiagnostic factor in depression and anxiety. Behav Res Ther. 2011; 49(3): 186-93[DOI][PubMed]
  • 12. Tull MT, Gratz KL. Further examination of the relationship between anxiety sensitivity and depression: the mediating role of experiential avoidance and difficulties engaging in goal-directed behavior when distressed. J Anxiety Disord. 2008; 22(2): 199-210[DOI][PubMed]
  • 13. Abasi I, Fata L, Sadeghi M, Banihashemi S, Mohammadee A. A comparison of transdiagnostic components in generalized anxiety disorder, unipolar mood disorder and nonclinical population. WASET. 2013; 7(12): 803-11
  • 14. Mennin DS, Holaway RM, Fresco DM, Moore MT, Heimberg RG. Delineating components of emotion and its dysregulation in anxiety and mood psychopathology. Behav Ther. 2007; 38(3): 284-302[DOI][PubMed]
  • 15. Mennin DS, McLaughlin KA, Flanagan TJ. Emotion regulation deficits in generalized anxiety disorder, social anxiety disorder, and their co-occurrence. J Anxiety Disord. 2009; 23(7): 866-71[DOI][PubMed]
  • 16. Olatunji BO, Wolitzky-Taylor KB, Sawchuk CN, Ciesielski BG. Worry and the anxiety disorders: A meta-analytic synthesis of specificity to GAD. Appl Prev Psychol. 2010; 14(1): 1-24
  • 17. Hong RY. Worry and rumination: differential associations with anxious and depressive symptoms and coping behavior. Behav Res Ther. 2007; 45(2): 277-90[DOI][PubMed]
  • 18. Yook K, Kim KH, Suh SY, Lee KS. Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. J Anxiety Disord. 2010; 24(6): 623-8[DOI][PubMed]
  • 19. Craske MG, Rapee RM, Jackel L, Barlow DH. Qualitative dimensions of worry in DSM-III-R generalized anxiety disorder subjects and nonanxious controls. Behav Res Ther. 1989; 27(4): 397-402[PubMed]
  • 20. Santanello AW, Gardner FL. The role of experiential avoidance in the relationship between maladaptive perfectionism and worry. Cognit Ther Res. 2007; 31(3): 319-32
  • 21. Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K. Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996; 64(6): 1152-68[PubMed]
  • 22. Berman NC, Wheaton MG, McGrath P, Abramowitz JS. Predicting anxiety: the role of experiential avoidance and anxiety sensitivity. J Anxiety Disord. 2010; 24(1): 109-13[DOI][PubMed]
  • 23. Shallcross AJ, Troy AS, Boland M, Mauss IB. Let it be: Accepting negative emotional experiences predicts decreased negative affect and depressive symptoms. Behav Res Ther. 2010; 48(9): 921-9[DOI][PubMed]
  • 24. Marx BP, Sloan DM. Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology. Behav Res Ther. 2005; 43(5): 569-83[DOI][PubMed]
  • 25. Berking M, Neacsiu A, Comtois KA, Linehan MM. The impact of experiential avoidance on the reduction of depression in treatment for borderline personality disorder. Behav Res Ther. 2009; 47(8): 663-70[DOI][PubMed]
  • 26. Vanderhasselt MA, Koster EH, Onraedt T, Bruyneel L, Goubert L, De Raedt R. Adaptive cognitive emotion regulation moderates the relationship between dysfunctional attitudes and depressive symptoms during a stressful life period: a prospective study. J Behav Ther Exp Psychiatry. 2014; 45(2): 291-6[DOI][PubMed]
  • 27. Fresco DM, Mennin DS, Heimberg RG, Ritter M. Emotion regulation therapy for generalized anxiety disorder. Cogn Behav Pract. 2013; 20(3): 282-300
  • 28. Berking M, Wupperman P, Reichardt A, Pejic T, Dippel A, Znoj H. Emotion-regulation skills as a treatment target in psychotherapy. Behav Res Ther. 2008; 46(11): 1230-7[DOI][PubMed]
  • 29. Hettema JM, Prescott CA, Kendler KS. Genetic and environmental sources of covariation between generalized anxiety disorder and neuroticism. Am J Psychiatry. 2004; 161(9): 1581-7[DOI][PubMed]
  • 30. Jardine R, Martin NG, Henderson AS. Genetic covariation between neuroticism and the symptoms of anxiety and depression. Genet Epidemiol. 1984; 1(2): 89-107[DOI][PubMed]
  • 31. Kokkonen M, Pulkkinen L. Extraversion and neuroticism as antecedents of emotion regulation and dysregulation in adulthood. Eur J Pers. 2001; 15(6): 407-24
  • 32. Muris P, Roelofs J, Rassin E, Franken I, Mayer B. Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Pers Individ Dif. 2005; 39(6): 1105-11
  • 33. Chawla N, Ostafin B. Experiential avoidance as a functional dimensional approach to psychopathology: an empirical review. J Clin Psychol. 2007; 63(9): 871-90[DOI][PubMed]
  • 34. Spinhoven P, Drost J, de Rooij M, van Hemert AM, Penninx BW. A longitudinal study of experiential avoidance in emotional disorders. Behav Ther. 2014; 45(6): 840-50[DOI][PubMed]
  • 35. Hayes SC, Strosahl K, Wilson KG, Bissett RT. Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record. 2004; 54(4): 553
  • 36. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011; 42(4): 676-88[DOI][PubMed]
  • 37. Kashdan TB, Morina N, Priebe S. Post-traumatic stress disorder, social anxiety disorder, and depression in survivors of the Kosovo War: experiential avoidance as a contributor to distress and quality of life. J Anxiety Disord. 2009; 23(2): 185-96[DOI][PubMed]
  • 38. Abasi E, Fti L, Molodi R, Zarabi H. Psychometric properties of persian version of acceptance and action questionnaire-II. [Persian] J of Psychological models and methods 2013; 2(3): 65-80
  • 39. Eysenck H, Eysenck S. Manual of Eysenck personality scales (EPS adult): comprising the EPQ-Revised (EPQ-R), EPQ-R short scale, Impulsiveness (IVE) questionnaire. 1991;
  • 40. Bakhshipour A, Bagharian KH. Psychometric properties of eysenck personality questionnaire-revised (epq-r) short scale. 2006;
  • 41. Meyer TJ, Miller ML, Metzger RL, Borkovec TD. Development and validation of the Penn State Worry Questionnaire. Behav Res Ther. 1990; 28(6): 487-95[PubMed]
  • 42. Brown TA, Antony MM, Barlow DH. Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample. Behav Res Ther. 1992; 30(1): 33-7[PubMed]
  • 43. Borjali A, Sohrabi F, Dehshiri GR, Golzari M. Psychometrics particularity of farsi version of Pennsylvania state worry questionnaire for college students. Applied Psychol. 2010; 4(1): 67-75
  • 44. Gross JJ, John OP. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol. 2003; 85(2): 348-62[PubMed]
  • 45. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment. 2004; 26(1): 41-54
  • 46. Asgari P, Pasha GHR, Aminiyan M. Relationship between emotion regulation, mental stresses and body image with eating disorders of women. [in Persian] Andisheh va raftar 2009; 4(13): 65-78
  • 47. Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychol Rev. 1988; 8(1): 77-100
  • 48. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988; 56(6): 893-7[PubMed]
  • 49. de Beurs E, Wilson KA, Chambless DL, Goldstein AJ, Feske U. Convergent and divergent validity of the Beck Anxiety Inventory for patients with panic disorder and agoraphobia. Depress Anxiety. 1997; 6(4): 140-6[PubMed]
  • 50. Fydrich T, Dowdall D, Chambless DL. Reliability and validity of the Beck Anxiety Inventory. J Anxiety Disord. 1992; 6(1): 55-61
  • 51. Kaviani H, Mousavi AS. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran University Medical Journal TUMS Publications. 2008; 66(2): 136-40
  • 52. Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression (The Guilford Clinical Psychology and Psychopathology Series)[Internet]. 1987;
  • 53. Dabson KS, Mohammad KHP. Psychometric characteristics of Beck depression inventory–II in patients with major depressive disorder. 2007;
  • 54. Baron RM, Kenny DA. The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986; 51(6): 1173
  • 55. Watson D, Clark LA, Weber K, Assenheimer JS, Strauss ME, McCormick RA. Testing a tripartite model: II. Exploring the symptom structure of anxiety and depression in student, adult, and patient samples. J Abnorm Psychol. 1995; 104(1): 15-25[PubMed]
  • 56. Muris P, Ollendick TH. The role of temperament in the etiology of child psychopathology. Clin Child Fam Psychol Rev. 2005; 8(4): 271-89[DOI][PubMed]
  • 57. Nigg JT. Temperament and developmental psychopathology. J Child Psychol Psychiatry. 2006; 47(3-4): 395-422[DOI][PubMed]
  • 58. Tortella-Feliu M, Balle M, Sese A. Relationships between negative affectivity, emotion regulation, anxiety, and depressive symptoms in adolescents as examined through structural equation modeling. J Anxiety Disord. 2010; 24(7): 686-93[DOI][PubMed]
  • 59. Lynch T, Robins CJ, Morse JQ, Krause ED. A mediational model relating affect intensity, emotion inhibition, and psychological distress. Behavior Therapy. 2001; 32(3): 519-36
  • 60. Suveg C, Hoffman B, Zeman JL, Thomassin K. Common and specific emotion-related predictors of anxious and depressive symptoms in youth. Child Psychiatry Hum Dev. 2009; 40(2): 223-39[DOI][PubMed]
  • 61. Gray JA. Brain systems that mediate both emotion and cognition. Cognition Emotion. 1990; 4(3): 269-88
  • 62. Pickett SM, Lodis CS, Parkhill MR, Orcutt HK. Personality and experiential avoidance: A model of anxiety sensitivity. Pers Individ Dif. 2012; 53(3): 246-50
  • 63. Mennin DS, Fresco DM. Emotion regulation therapy. 2014;
  • 64. Kashdan TB, Barrios V, Forsyth JP, Steger MF. Experiential avoidance as a generalized psychological vulnerability: comparisons with coping and emotion regulation strategies. Behav Res Ther. 2006; 44(9): 1301-20[DOI][PubMed]
  • 65. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: An experiential approach to behavior change. 1999;
  • 66. Linehan MM. Skills training manual for treating borderline personality disorder. 1993;
  • 67. Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression. 2012;
  • 68. Greenberg LS, Watson JC. Emotion-focused therapy for depression. 2006;
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