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

Behav Cogn Psychother. 2017 Jan;45(1):73-78. doi: 10.1017/S1352465816000199. Epub 2016 May 23.


Background: Beliefs that it is unacceptable to experience or express negative emotions have been found to be associated with various clinical problems. It is unclear how such beliefs, which could be viewed as a form of unhelpful perfectionism about emotions, may contribute to symptomatology.

Aims: This study investigated two hypotheses: a) greater endorsement of beliefs about the unacceptability of negative emotions will be associated with greater emotional avoidance and lower levels of support-seeking and self-compassion; b) 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.

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

Results: Beliefs about the unacceptability of negative emotions were significantly associated with more emotional avoidance and less self-compassion and support-seeking. The relationships between beliefs about emotions and depression, anxiety and fatigue were significantly mediated by self-compassion and emotional avoidance but not social support-seeking.

Conclusions: Future research should investigate whether interventions that pay particular attention to emotional avoidance and self-compassion, such as mindfulness-based therapy or modified forms of CBT, may be beneficial in reducing distress and fatigue associated with beliefs about the unacceptability of negative emotions.

Keywords: Emotional avoidance; emotional processing; help-seeking; perfectionism; self-compassion; social support.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety / psychology*
  • Anxiety / therapy
  • Avoidance Learning
  • Cross-Sectional Studies
  • Culture*
  • Depression / psychology*
  • Depression / therapy
  • Emotions*
  • Empathy
  • Fatigue / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Negotiating / psychology*
  • Pessimism / psychology
  • Psychiatric Status Rating Scales
  • Social Support
  • Surveys and Questionnaires