Avoidance and Depression: Evidence for Reinforcement as a Mediating Factor

Behavioral Activation theory (Martell, Addis, & Jacobson, 2001) posits that a pattern of excessive use of avoidant coping strategies removes an individual from environmental sources of reward and reinforcement and subsequently leads to the development (or maintenance) of depressive symptoms. This investigation examined this theory by establishing measures of environmental reward as mediators between avoidance and depression, while further demonstrating that there is a strong connection between avoidance and depression independent of anxiety. Reward was measured by both self-report questionnaire (Reward Probability Inventory; Carvalho et al., under review) and daily activity diary ratings (Hopko, Bell, Armento, Hunt, & Lejuez, 2003), which were considered proxy measures for positive reinforcement. Avoidance was primarily assessed with the Cognitive-Behavioral Avoidance Scale (CBAS; Ottenbreit & Dobson, 2004), which distinguishes between cognitive and behavioral avoidance. When anxiety was controlled, reward significantly mediated the relationships between depression and cognitive, behavioral, and total avoidance. However, when structural equation modeling incorporating latent variables for avoidance and reward tested the same model, reward was not a mediator. In post-hoc mediation analyses, gender differences emerged whereby among females, diary-measured reward only mediated the relation between cognitive avoidance and depression when anxiety was controlled, while in males diary reward was a mediator with all three forms of avoidance. This investigation, while producing mixed results overall, provides initial support for the proposed mediating role of reinforcement in the relationship between avoidance and depression and further highlights the relevance of avoidance and reinforcement in the conceptualization of depression.