Beliefs about Emotions, Depression, Anxiety and Fatigue: A Mediational Analysis

Beliefs that it is unacceptable to experience or express negative emotions have been reported to be elevated in a range of clinical problems. These include eating disorders, anxiety and depression and chronic fatigue syndrome. It is possible that the experience of such problems may result in these beliefs becoming more negative; however, it is also possible that they contribute to the development or maintenance of such problems. In this regard, the present study investigates if individuals with stronger beliefs about the unacceptability of expressing or experiencing negative emotions will seek less social support. It also presumes that these individuals report greater emotional avoidance and lower levels of self-compassion. Further, it is predicted that these beliefs about emotions will be associated with higher levels of symptoms of depression, anxiety and fatigue; and that this relationship will be mediated by social support-seeking, emotional avoidance and self-compassion.

Online questionnaires were completed by 451 community participants. Mediational analyses were undertaken to investigate emotional avoidance, social support-seeking and self-compassion. These were looked into as supposed mediators of the relationship between beliefs about emotions and symptoms of depression, anxiety and fatigue.

For each mediation model, beliefs about emotions were significantly associated with self-compassion, emotional avoidance and social support-seeking. The total effect of beliefs about emotions on each of the outcome variables was significant and the direct effect non-significant. Emotional avoidance and self-compassion significantly predicted depression, anxiety and fatigue. The confidence intervals for the indirect effects of both of these mediating variables on the three outcome variables excluded zero. Thus, both emotional avoidance and self-compassion significantly mediated the relationship between beliefs. Social support-seeking did not significantly predict depression, anxiety or fatigue. It also included zero within its confidence intervals. Thus, it did not significantly mediate the relationship between beliefs about emotions and depression, anxiety or fatigue.

In conclusion, the relationship between beliefs about the unacceptability of negative emotions and depression, anxiety and fatigue is mediated by lower levels of self-compassion; and greater levels of emotional avoidance. Social support-seeking was not found to be a significant mediator of this relationship. Researchers suggest therapies like mindfulness-based cognitive therapy to address perfectionist beliefs about emotions for those experiencing clinical issues. This will encourage openness to emotions and self-compassion specifically as core elements of the treatment. Moving forward, future research should investigate interventions that pay particular attention to emotional avoidance and self-compassion. These include mindfulness-based therapy or modified forms of CBT. This could help assess if they are beneficial in reducing distress and fatigue associated with beliefs about the unacceptability of negative emotions.