Processes underlying depression: Risk aversion, emotional schemas, and psychological flexibility
The purpose of the present study was to examine three theoretical models that identify underlying processes that contribute to depression-Risk Aversion (Leahy, 1997a), Emotional Schemas (Leahy, 2002), and Psychological Flexibility (Hayes, Strosahl, & Wilson, 2003). In addition, we examined the relationship among these transdiagnostic variables: 425 adult psychotherapy patients were tested on the Risk Aversion Questionnaire, the Leahy Emotional Schema Scale, the Acceptance and Action Questionnaire, and the Beck Depression Inventory. As predicted, Psychological Flexibility was related to more positive emotional schemas. In particular, emotional schemas reflecting Invalidation, Lack of Consensus, Blame, Lack of Higher Values, and Incomprehensibility were related to less psychological flexibility. Further, 23 of 25 Risk Aversion dimensions were related to psychological flexibility, indicating that experiential avoidance is part of a risk averse strategy. Less discouragement, less overgeneralizing loss, greater perception of resources, and taking credit for success were the best predictors of less psychological flexibility, suggesting that the cognitive components of risk assessment are implicated in experiential avoidance. In addition, every one of the 25 risk averse dimensions was related to negative beliefs about emotions. Consistent with these models, Risk Aversion, Negative Beliefs about Emotion, and Psychological Flexibility were significantly related to depression and to each other. Multiple regression analyses indicated that depression was best predicted by Risk Aversion and Psychological Flexibility. These findings are discussed in terms of the relative contributions of beliefs about emotional experience and risk tolerance as underlying processes affecting psychological flexibility and depression. © 2012 International Association for Cognitive Psychotherapy.
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