Clarifying relations of emotion regulation, emotional avoidance and anxiety symptoms in a community-based treatment-seeking sample

Rachel C. Bock, Lucas D. Baker, Emily A. Kalantar, Christopher R. Berghoff, Joel C. Stroman, Kim L. Gratz, Matthew T. Tull

Research output: Contribution to journalArticlepeer-review


Objectives: Anxiety is a global problem that is readily treatable with psychosocial interventions, though many individuals do not benefit following participation in extant treatment protocols. Accordingly, clarification of process-related variables that may be leveraged to enhance outcomes appears warranted. Emotion regulation (ER) is a robust correlate of anxiety symptoms and is often targeted in behavioural treatments applied to anxiety-related problems. Yet, some evidence suggests ER difficulties may be a proxy variable for emotional avoidance (EA). Clarifying the relative influence of ER and EA on anxiety symptom severity may improve specificity in targeting behavioural processes within psychosocial treatments designed to alleviate anxiety-related suffering. Accordingly, we examined relations of ER and EA to anxiety symptom severity after accounting for anxiety sensitivity and anxiolytic medication use in a community-based treatment-seeking sample. Design: A four-step hierarchical linear regression analysis of cross-sectional data provided by a community-based treatment-seeking sample. Methods: Totally, 120 participants (Mage = 39.18; Female = 58.3%) completed a questionnaire packet upon intake to an anxiety disorders clinic. Results: EA and ER were strongly correlated, and each accounted for significant variance over and above model covariates. EA was a dominant risk factor for anxiety symptom severity, as ER was not a significant predictor (p =.073) following the inclusion of EA in the model (p =.006). Conclusions: EA appears to be a dominant risk factor, and ER a proxy risk factor, for anxiety symptom severity. EA may be an avenue for greater treatment specificity for those with anxiety symptoms.

Original languageEnglish
Pages (from-to)393-404
Number of pages12
JournalPsychology and Psychotherapy: Theory, Research and Practice
Issue number2
StatePublished - Jun 2024


  • anxiety
  • anxiety sensitivity
  • emotion regulation
  • emotional avoidance


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