Estimating the effect of basic behavioral processes (access to reinforcers and experiential avoidance) on emotional disorders as transdiagnostic variables: A systematic review

This systematic review we sought to identify the effects of core behavioral processes (experiential avoidance and access to reinforcement) on emotional disorders. Although transdiagnostic research has demonstrated a close relationship between negative reinforcers and processes such as experiential avoidance in the acquisition and maintenance of emotional problems, no studies are available that relate access to positive reinforcers and their functions such as gaining attention, sensory reinforcement and access to tangibles with internalizing problems such as anxiety and depression.

Studies on response-contingent positive reinforcement, negative reinforcement, experiential avoidance, access to reinforcers, and emotional difficulties (i.e., depression, unipolar depression, anxiety, emotional distress, and affective disorder) were included. Seven databases were used for this research: PubMed, MEDLINE, ScienceDirect, Scopus, PsycINFO, PsyARTICLES, SciELO Citation Index of scientific articles, and ProQuest Dissertations from 2013 to 2024. Fleiss’ Kappa was used to determine the inter-judge reliability index. Subsequently, a coding book was created, incorporating 12 criteria through which the qualitative synthesis was generated.

a total of 21 studies (n = 2776) were included for the qualitative synthesis, comprising nine articles on access to reinforcement and twelve on experiential avoidance and their relationship with emotional disorders. A direct relationship was found between the study variables, and evidence was identified of the mediating role of access to reinforcers and experiential avoidance in the presence of emotional symptomatology.

A decade of research supports a relationship between basic behavioral processes and the presence of emotional disorders and related psychopathologies, suggesting that these variables should a focus of attention as an explanatory and treatment-directing variable.