Experiential Avoidance as a Transdiagnostic Mediator in the Relationship Between Intolerance of Uncertainty, Maladaptive Perfectionism, and Psychiatric Symptoms: Structural and Causal Mediation Analyses in a Clinical Sample

PMCID: PMC12178104

PMID: 40536179

DOI: 10.1002/cpp.70102

Journal: Clinical psychology & psychotherapy

Publication Date: 2025-6-19

Authors: Gerdan G, Salcioglu E

Key Points

• Experiential avoidance fully mediates the relationship between intolerance of uncertainty, maladaptive perfectionism, and psychiatric symptoms
• EA explained 1.254 standard deviations in the relationship between intolerance of uncertainty and psychiatric symptoms
• Assessing and addressing avoidance strategies may be crucial in reducing symptom burden for patients with anxiety and depression-related disorders

Summary

This study investigated the complex interplay between intolerance of uncertainty (IU), maladaptive perfectionism (MP), experiential avoidance (EA), and psychiatric symptoms (PS) across anxiety and depression-related disorders. Using structural equation modeling with a sample of 221 participants, researchers examined how EA mediates the relationship between IU, MP, and symptom severity. The findings revealed that EA fully mediates the connections between these psychological processes, explaining 54.5% of variance in experiential avoidance and 62.5% of variance in psychiatric symptoms.

The research demonstrates that as IU and MP increase, individuals are more likely to engage in avoidance strategies, which subsequently intensify psychological symptoms. Causal mediation analyses showed that EA explained 1.254 standard deviations in the IU-PS relationship and 0.871 standard deviations in the MP-PS relationship. These results underscore the critical role of avoidance behaviors in maintaining and exacerbating psychological distress across various clinical presentations.