Research and clinical attention in psychology has focused heavily on negative automatic thoughts and their role in symptoms of psychopathology and maladaptive behavior; however, the role of thoughts that appear to be overly positive in content has received much less attention. Recent work in the cognitive-behavioral treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) has identified overly positive thoughts that may be associated with avoidance and functional impairment.
We defined, described, and measured Avoidant Automatic Thoughts (AAT) in the daily lives of 101 undergraduate students using ecological momentary assessment and tested hypotheses about the association of these thoughts with ADHD symptoms and in-the-moment avoidance and negative emotion. Data were collected at baseline and up to three times per day for six days and analyzed using multilevel modeling.
We found that AAT were frequent daily occurrences for the undergraduates in our sample and that recent presence of AAT was associated with greater task avoidance and inattentive symptoms at the momentary level. AAT were not, however, associated with momentary negative emotion. Participants’ general level of ADHD symptoms predicted greater momentary AAT, task avoidance, negative emotion and negative thoughts and less positive emotion.
This study introduces AAT as a construct with potential research and clinical utility for understanding, predicting, and intervening in problematic avoidance behaviors that reduce people’s quality of life and prevent them from reaching their meaningful goals.
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The authors would like to thank Dr. Alex Schoemann and Dr. L. Andrew Bell for assisting the first author in learning multilevel modeling and visualization techniques in R. They would also like to thank Dr. Susan Wenze for consultation on ecological momentary assessment and Dr. J. Russell Ramsay for helpful comments on a draft of the manuscript. The authors also thank the undergraduate researchers who assisted with data collection: Julia Evans, Destiny Hunt, Zodok Martinez, Malcolm Pittman, Celia Satter, Caitlin Wiegert, and Ryan Wigginton.
L. Knouse is a member of the Professional Advisory Board of Children and Adults with ADHD (CHADD) and is a clinical and research consultant for Get Inflow, LTD. The other authors have no competing interests to declare.
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Knouse, L.E., Ziegler, M., Lavine, I. et al. Avoidant Automatic Thoughts are Associated with Task Avoidance and Inattention in the Moment. Cogn Ther Res (2023). https://doi.org/10.1007/s10608-023-10410-8