The role of cognitive fusion and experiential avoidance in anxiety and depression

Camilla Cookson

Research output: ThesisDoctoral Thesis

2198 Downloads (Pure)


This research used the theory underpinning Acceptance and Commitment Therapy (ACT) to develop our understanding of anxiety and depression. ACT proposes that cognitive fusion (CF) and experiential avoidance (EA) are two processes fundamental to psychological distress. However, CF and EA’s role in anxiety and depression in the context of one another has not been established. This study aimed to test the hypotheses that CF and EA would make both unique and interrelated contributions to explaining a) variance in symptoms of anxiety and depression, and b) the effect of three different internal (worry and rumination) and external (stressful life-events) vulnerabilities to anxiety and depression.

A correlational cross-sectional design was conducted in a student (n=106) and clinical sample (n=57). The hypotheses were additionally tested longitudinally in the student sample (n=97). Cross-sectionally, in students, only CF explained unique variance in anxiety and depression and mediated the relationships between vulnerabilities to and indicators of symptomology. These results were not replicated longitudinally. In the clinical sample, CF acted in concert with EA in explaining variance in symptomology and in mediating the effect of all three vulnerability factors.

These results partially supported CF and EA as core transdiagnostic processes in anxiety and depression, and therefore key targets for prevention and treatment. CF appeared particularly relevant to students’ mental health, with CF’s serial effect through EA increasingly important where clinically significant symptoms were present. Further longitudinal and experimental research is needed to verify the causal assumptions inherent in this study.
Original languageEnglish
Awarding Institution
  • Royal Holloway, University of London
  • Kingston, Jessica, Supervisor
  • Luzon, Olga, Supervisor
Award date1 Nov 2016
Publication statusUnpublished - 2016

Cite this