Linking cognitive avoidance and GAD symptoms: The mediating role of fear of emotion

Although cognitive avoidance has been linked to generalized anxiety disorder (GAD), the mechanism that may account for this association has not been fully elucidated. The current study uses structural equation models to evaluate the relationship between cognitive avoidance and symptoms of GAD in a large unselected sample (n = 1220), and to examine whether subjective fear of emotion partially mediate this relationship. Results support partial mediation, and follow-up analyses suggest that the pattern of relations among fear of emotion, cognitive avoidance, and GAD symptoms is invariant for men and women. However, subsequent analysis revealed equivalence of meditational models where cognitive avoidance leads to GAD symptoms and vice versa. The implications of these findings for better understanding the etiology, maintenance, and treatment of GAD are discussed.