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Aims <p>Experiential avoidance (EA) has been linked to depression, but evidence of this maladaptive coping mechanism in bipolar disorder (BD) is limited. This longitudinal case‒control study aimed to investigate the presence of EA in BD and its relationship with depressive symptom severity at baseline and during hospitalization, as well as exploring sex differences.</p> Methods <p>We compared EA in a cohort of 48 (52.1% female) hospitalized BD patients with a cohort of healthy controls (HCs; <i>n</i> = 24), matched for age, sex, and education level. The Brief Experiential Avoidance Questionnaire, Childhood Trauma Questionnaire-Short Form, and Symptom Checklist-90 were administered at baseline. The evolution of patients’ depressive symptoms during hospitalization was monitored biweekly with the HAMD-17.</p> Results <p>At baseline, we observed higher EA levels in BD patients than in HCs (Cohen’s <i>d</i> 0.85, <i>t</i>(46) = 3.386; <i>p</i> = 0.002). We found a significant interaction effect between sex and depressive symptoms in patients (<i>F</i>(1,47) = 9.561, <i>p</i> = 0.003), with a positive association between EA and depressive symptoms in men (<i>r</i> = 0.633) but not in women. The mixed model analysis revealed no significant effect of baseline EA on the depression trajectory. Neither the duration of illness nor childhood emotional trauma was significantly related to EA.</p> Conclusion <p>Our study highlights EA as a maladaptive coping mechanism in male but not female BD patients suggested by its link with depression severity. Sex-specific coping mechanisms might differentially impact the course of BD illness and should be considered in the context of psychotherapy.</p>

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Experiential Avoidance Has a Sex-Specific Relationship with Depressive Symptoms in Patients with Bipolar Disorder

  • 期刊论文

  • 发表日期：

    2025年8月27日

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  • Tatjana Gauwloos,
  • Livia De Picker,
  • Barbara Depreeuw,
  • Rudi De Raedt,
  • Manuel Morrens

摘要

Aims

Experiential avoidance (EA) has been linked to depression, but evidence of this maladaptive coping mechanism in bipolar disorder (BD) is limited. This longitudinal case‒control study aimed to investigate the presence of EA in BD and its relationship with depressive symptom severity at baseline and during hospitalization, as well as exploring sex differences.

Methods

We compared EA in a cohort of 48 (52.1% female) hospitalized BD patients with a cohort of healthy controls (HCs; n = 24), matched for age, sex, and education level. The Brief Experiential Avoidance Questionnaire, Childhood Trauma Questionnaire-Short Form, and Symptom Checklist-90 were administered at baseline. The evolution of patients’ depressive symptoms during hospitalization was monitored biweekly with the HAMD-17.

Results

At baseline, we observed higher EA levels in BD patients than in HCs (Cohen’s d 0.85, t(46) = 3.386; p = 0.002). We found a significant interaction effect between sex and depressive symptoms in patients (F(1,47) = 9.561, p = 0.003), with a positive association between EA and depressive symptoms in men (r = 0.633) but not in women. The mixed model analysis revealed no significant effect of baseline EA on the depression trajectory. Neither the duration of illness nor childhood emotional trauma was significantly related to EA.

Conclusion

Our study highlights EA as a maladaptive coping mechanism in male but not female BD patients suggested by its link with depression severity. Sex-specific coping mechanisms might differentially impact the course of BD illness and should be considered in the context of psychotherapy.