Approach and avoidance tendencies in depression and anxiety disorders

Publication Type:

Journal Article


Psychiatry Research, Volume 256, p.475-481 (2017)




Behavior Inhibition; Activation; Motivation; AAT; Automatic


Anxiety is linked to increased avoidance and inhibition, whereas depression is linked to decreased approach and
diminished behavioral activation. Although these notions are widely recognized, systematic investigation of
approach-avoidance tendencies is lacking across these diagnostic groups. Participants (mean age = 45.6; 65.8%
female) were subdivided in healthy controls (405), remitted patients (877) and currently anxious (217), depressed
(154) or comorbid (154) patients. Automatic approach-avoidance tendencies in reaction to facial expression
were assessed using the Approach-Avoidance-Task (AAT). Self-reported trait approach and avoidance
tendencies were assessed using the BIS/BAS scale. Severity of psychopathology was assessed to examine doseresponse
relationships. We did not find any consistent associations of automatic approach-avoidance tendencies
with psychiatric variables. In contrast, medium to large differences in BIS scores showed increased trait
avoidance tendencies in all patient groups relative to healthy controls. Overall, it seems that increased trait
avoidance, rather than decreased approach, is a characteristic of affective disorders. This holds for both depressed
and anxious patients and more strongly so in severe and chronic patients. It underlines the importance to
address trait avoidance tendencies in the treatment of affective disorders.