Assessment & Research

Experiential avoidance and problem behavior: a mediational analysis.

Kingston et al. (2010) · Behavior modification 2010
★ The Verdict

Experiential avoidance is the single process that turns past trauma into today’s mixed problem behaviors.

✓ Read this if BCBAs who see adults or teens with trauma histories and multiple topographies of problem behavior.
✗ Skip if RBTs looking for quick discrete-trial programs.

01Research in Context

01

What this study did

Kingston et al. (2010) asked why one client can show many problem behaviors. They tested whether 'experiential avoidance' is the shared engine. The team ran a single survey on adults with mixed mental-health diagnoses. They used a statistical model called structural equation modeling to see if avoidance sits between past trauma and current problems.

02

What they found

Avoidance explained all the link between childhood trauma and later problem behaviors. Negative feelings still mattered, but only because they fed avoidance. In plain words: hurt people act out when they refuse to feel pain.

03

How this fits with other research

Bakhshaie et al. (2016) repeated the idea with daily smokers who had trauma. Smoking-specific avoidance fully carried the effect of anxiety sensitivity to heavier smoking. The same pathway shows up across drugs, worry, and autism traits.

Root et al. (2017) moved the lens to autistic kids. Sensory hypersensitivity, another avoidance-like process, explained why anxiety and rigid sameness travel together. Brosnan et al. (2025) found the same full-mediation pattern with intolerance of uncertainty driving deliberation in autistic adults.

Together these papers say: avoidance processes are the bridge from early risk to many topographies of trouble.

04

Why it matters

When a client lists five different problem behaviors, do not chase each one. Screen for experiential avoidance first. Add the Brief Experiential Avoidance Questionnaire to your intake packet. If scores are high, teach acceptance and defusion before you write five separate behavior plans. You will save time and hit the real driver.

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Add one avoidance measure to your intake forms and score it before you write any behavior plan.

02At a glance

Intervention
not applicable
Design
other
Sample size
290
Population
mixed clinical
Finding
positive

03Original abstract

Despite their formal dissimilarity, problem behaviors (e.g., substance misuse, binge eating, self-harm) may share a common function. According to Acceptance and Commitment Therapy (ACT), this shared function is Experiential Avoidance, the process of avoiding, escaping or otherwise altering unwanted private events (e.g., thoughts, feelings, memories) and the contexts that elicit them. Structural Equation Modeling was used cross-sectionally with data from a clinical opportunity sample ( N = 290) to test (a) whether problem behavior covariance was associated with experiential avoidance, and (b) whether experiential avoidance mediated the relationships between historical and dispositional risk factors (childhood trauma and negative affect intensity, respectively) and the tendency to engage in problem behaviors. Analysis showed that experiential avoidance contributed to the covariation of problem behaviors, and that it fully mediated the relationships between both risk factors and problem behavior. Thus, experiential avoidance may be a key process to target in the management of individuals with behavior problems.

Behavior modification, 2010 · doi:10.1177/0145445510362575