anales de psicología / annals of psychology © Copyright 2020: Editum. Servicio de Publicaciones de la Universidad de Murcia.

Murcia (Spain)
2020, vol. 36, nº 3 (october), 457-467 ISSN print edition: 0212-9728. ISSN online edition (http://revistas.um.es/analesps): 1695-2294.
https://doi.org/10.6018/analesps.397711 Online edition License Creative Commons 4.0: BY-SA

Cognitive Avoidance Questionnaire: Factor structure and psychometric properties.

Jose M. Latorre1, 2, Marta Nieto1, 2, Laura Ros1, 2, María A. Font3, Jesús Heras†1, 2, and Jorge J. Ricarte1, 2

1 University of Castilla-La Mancha. Department of Psychology, Albacete (Spain)

2 Applied Cognitive Psychology Unit. University of Castilla-La Mancha (Spain)
3 Unidad de Salud Mental, Hospital General de Villarrobledo, SESCAM, Albacete (Spain)

Título: Cuestionario de Evitación Cognitiva: estructura factorial y propie- Abstract: Cognitive avoidance refers to strategies and efforts toward pre-
dades psicométricas. vention of aversive experiences and events that provoke anxiety. The pre-
Resumen: La evitación cognitiva se refiere a las estrategias y esfuerzos di- sent study analyzed the factor structure and psychometric properties of the
rigidos a prevenir experiencias negativas y eventos aversivos que provocan Spanish version of the Cognitive Avoidance Questionnaire (CAQ; Sexton
ansiedad. El presente estudio analizó la estructura factorial y las propieda- & Dugas, 2008), an instrument which assesses five worry-related cognitive
des psicométricas de la versión española del Cuestionario de Evitación avoidance strategies. The Spanish translation was administered to a non-
Cognitiva (CAQ; Sexton & Dugas, 2008), un instrumento que evalúa cinco clinical sample of 614 participants (18-82 years). The total scale and sub-
estrategias de evitación cognitiva relacionadas con la preocupación. La tra- scales showed good to excellent internal consistency. Using confirmatory
ducción al español se administró a una muestra no clínica de 614 partici- factor analysis, a second-order model (i.e., five first-order factors and one
pantes (18-82 años). La escala total y las subescalas mostraron una consis- second-order factor) showed the best fit between the theoretical structure
tencia interna de buena a excelente. Utilizando el análisis factorial confir- and the empirical data. Evidence of convergent and discriminant validity
matorio, se halló un modelo de segundo orden (i.e., cinco factores de pri- was obtained through analysis of the correlations of the questionnaire with
mer orden y un factor de segundo orden) que mostró el mejor ajuste entre measures of worry, thought suppression, rumination and coping styles.
la estructura teórica y los datos empíricos. Se obtuvo evidencia de validez The results yielded satisfactory preliminary data on the Spanish adaptation
convergente y discriminante a través del análisis de las correlaciones del of the CAQ, which could provide for further advances in clinical practice
cuestionario con medidas de preocupación, supresión del pensamiento, and research on cognitive processes and anxiety disorders.
rumiación y estilos de afrontamiento. Los resultados arrojaron datos preli- Keywords: Cognitive Avoidance Questionnaire; Anxiety disorders; Worry;
minares satisfactorios sobre la adaptación española del CAQ que podría Coping strategies; Rumination; Psychometrics.
proporcionar mayores avances en la práctica clínica y la investigación sobre
procesos cognitivos y trastornos de ansiedad.
Palabras clave: Cuestionario de Evitación Cognitiva; Trastornos de ansie-
dad; Preocupación; Estrategias de afrontamiento; Rumiación; Propiedades
psicométricas.

Introduction & Hirsch, 2017; Servatius, 2016). Most of these disorders are
characterized by worry, particularly in the case of generalized
Avoidance, understood as the tendency to escape private in- anxiety disorder (GAD; American Psychiatric Association,
ternal experiences such as emotions, thoughts, and memo- 2013; Hirsch, Perman, Hayes, Eagleson, & Mathews, 2015).
ries, is a natural reaction that is critical to individuals’ survival Worry has been defined as a chain of negative thoughts that
(Hayes, Wilson, Gifford, Follette, & Strosahl, 1996). Howev- are predominantly verbal and aimed at problem-solving
er, this response may be maladaptive when excessive or un- (Borkovec, Robinson, Pruzinsky, & DePree, 1983). The
necessary, being considered a risk factor for developing and avoidance theory of worry and GAD considers worry, in
maintaining emotional disorders, such as depressive and anx- part, to be a strategy for avoiding threatening images and the
iety disorders (Barajas, Garra, & Ros, 2017; Schäfer, Naum- autonomic arousal they induce (Borkovec, Alcaine, & Behar,
man, Holmes, Tuschen-Caffier, & Samson, 2017; Struijs et 2004). In other words, individuals present excessive worry as
al., 2018). In relation to such approaches, since the emer- a preparatory strategy in response to a threat, with the aim of
gence of the “Third Wave” of therapies, much attention has averting the cognitive and physiological symptoms of anxiety
been focused on the role of cognitive, behavioral and emo- (Behar et al. 2009). Consequently, cognitive avoidance has
tional avoidance in psychopathology (Eifert & Forsyth, 2005; been considered a key process for both the prediction and
Hayes, 2016). maintenance of worry (Dickson, Ciesla, & Reilly, 2012).
Cognitive avoidance entails a variety of strategies, such as With further regard to the conceptualization of worry,
distraction, worry, and thought suppression, aimed at avoid- the literature has suggested parallels with difficult to control
ing or escaping thoughts about undesirable situations or repetitive thoughts concerning personal problems (i.e., ru-
problems (Sagui-Heson, 2017). Importantly, thought control mination). Ruminative thought occurs in both normal indi-
strategies have been associated with anxiety disorders (Al- viduals and clinical patients and is also a feature of anxiety
dao, Nolen-Hoeksema, & Schweizer, 2010; Goodwin, Yiend, disorders (Ricarte, Aizpurúa, Ros, Latorre, & Raes, 2018).
Worry and rumination may overlap between 16 and 21% in
both non-clinical and clinical samples (Segerstrom, Tsao,
* Correspondence address [Dirección para correspondencia]: Alden, & Craske, 2000). Moreover, they tend to be passive
Dr. Marta Nieto López, Department of Psychology, Faculty of Medicine,
University of Castilla La Mancha, Avenida de Almansa 14, 02006 Albacete phenomena which interfere with problem-solving and are
(Spain). E-mail: Marta.Nieto@uclm.es apt to aggravate anxiety (Matthews & Wells, 2004). It has al-
(Article received: 01-10-2019; revised: 04-11-2019; accepted: 11-02-2020) so been posited that both processes may be the paradoxical
- 457 -
458 Jose M. Latorre et al.

outcome of attempts at thought suppression (Dickson et al., validity. In addition, we analyzed the contribution of the
2012). With regard to the differences between the two pro- translated version in predicting worry after evaluating other
cesses, it has been suggested that worry is used to anticipate variables of cognitive avoidance.
danger and prepare for action, while rumination is past-
oriented (Capobianco, Morris, & Wells, 2018). Rumination Method
has been related to depressive disorders, although it may also
be present in anxiety (Nolen-Hoeksema, 2000), while worry Participants
has been more exclusively associated with anxious symptoms
(Behar et al. 2009). Hence, taking into account the relation The study sample comprised 614 Spanish Caucasian par-
between these strategies and cognitive avoidance and be- ticipants from a non-clinical population (74.3% women; age
cause of the implications for the understanding of emotional range 18-82 years; M = 24.05, SD = 11.84), of whom 553
disorders (Hearn, Donovan, Spence, & March, 2018; New- young adults were recruited from among university students
man, Llera, Erickson, Przeworski, & Castonguay, 2013; (77.1% women; age range 18-30 years; M = 20.03, SD =
Østefjells et al., 2017; Watkins & Moulds, 2009), an instru- 2.68); 57 middle-aged persons were recruited by means of
ment is needed to assess a wide range of cognitive avoidance public announcements (58.5% women; age range 31-59
strategies and related variables. years; M = 45.89, SD = 10.40); and 24 older adults were re-
There exists a questionnaire of the above characteristics cruited from active aging associations in different urban are-
originally published in French under the title of Question- as of the region of Castilla-La Mancha (45.8 % women; age
naire d’evitement cognitif (QEC; Gosselin et al., 2002). The range 60-82 years, M = 65.75, SD = 5.72). All the partici-
QEC measures cognitive avoidance using five sub-scales pants were of middle-high socioeconomic status, with a
(Thought Suppression, Thought Substitution, Distraction, mean yearly income of between 25,000 and 56,000 euros.
Avoidance of Threatening Stimuli, and the Transformation The inclusion criteria were as follows: 1) being able to read
of Images into Thoughts). The first 41-item version was de- and write; 2) for the group of older adults, presenting no
signed by a group of clinical researchers in 1996. The ques- signs of cognitive impairment at the time of assessment, as
tionnaire was subsequently shortened to 25 items. In adult measured using the Spanish version of the Mini-Mental Sta-
and adolescent populations, the results were fitted to a five- tus Examination (‘Mini-Examen Cognoscitivo’ [MEC], Lo-
factor structure, with good psychometric properties, criteri- bo, Sanz, Marcos, & Zaracemp, 2002); and 3) once informed
on validity, and convergent and discriminant validity. Sexton of the study aims, agreeing to participate and giving signed
and Dugas (2008) developed the adaptation and validation of informed consent. No participant was excluded from the
the English version of the Cognitive Avoidance Question- study under these criteria.
naire (CAQ), which demonstrated good to excellent internal
consistency. Confirmatory factor analysis found support for Measures
the five-factor structure, despite the goodness of fit being
lower than expected. Their version showed evidence of con- Cognitive Avoidance Questionnaire
vergent validity related to measures of worry, thought sup-
pression and coping styles. As a measure of discriminant va- The CAQ is a 25-item self-report questionnaire that as-
lidity, the scale was negatively correlated with information- sesses the tendency to use cognitive avoidance as a strategy
seeking in controllable situations. when dealing with threatening intrusive thoughts (Sexton &
Dugas, 2008). The scale has a five-factor structure: Factor 1
The current study = Thought Suppression subscale (items 1, 2, 5 6, 14); Factor 2 =
Thought Substitution subscale (items 4, 11, 17, 20, 25); Factor 3
There is a need for an instrument in Spanish to assess = Distraction subscale (items 8, 10, 12, 13, 21); Factor 4 =
cognitive avoidance as this would promote advances in clini- Avoidance of Threatening Stimuli subscale (items 7, 9, 16, 18,
cal practice and subsequent studies on cognitive processes 22); and Factor 5 = Transformation of Images into Thoughts sub-
and mental disorders, especially GAD. In this sense, the im- scale (items 3, 15, 19, 23, 24). Responses are scored on a 5-
portance of these types of transdiagnostic constructs is in- point interval scale, ranging from 1 = not at all typical to 5 =
creasing, as functional avoidance is a widely used measure in completely typical. Higher scores indicate a greater tendency to
different disciplines, but lacks specific, validated tests. Thus, cognitively avoid threatening internal events. The CAQ total
and given that, to the best of our knowledge, there is no exhibited excellent internal consistency (α = .95). The five
Spanish version of the CAQ, the aim of this work was to subscales showed internal consistencies as follows: Thought
translate the questionnaire by Sexton and Dugas (2008) from Suppression, α = .86; Thought Substitution, α = .73; Distrac-
English into Spanish, and analyze its psychometric proper- tion, ɑ = .89; Avoidance of Threatening Stimuli, α = .87; and
ties in a non-clinical sample of Spanish participants. More Transformation of Images into Thoughts, α = .87.
specifically, the present study analyzed the factor structure of
the CAQ using confirmatory factor analysis (CFA), examin-
ing its internal consistency and convergent and discriminant

anales de psicología / annals of psychology, 2020, vol. 36, nº 3 (october)

 Cognitive Avoidance Questionnaire: Factor structure and psychometric properties 459

White Bear Suppression Inventory Ricarte, Aizpurúa, Ros, Latorre, & Raes, 2018) comprises
four statements derived from the Leuven Adaptation of the
The White Bear Suppression Inventory (WBSI; Wenger Rumination on Sadness Scale (Raes, Hermans, Williams, Bi-
& Zanakos, 1994) is a one-factor measure of the general jttebier, & Eelen, 2007). Participants are asked to rate on a
tendency to suppress thoughts as a mental control strategy. scale from 1 to 10 (never to very often) the frequency with
It comprises 15 items scored on a 5-point Likert-type scale which they do what is described in the four sentences when
ranging from strongly disagree to strongly agree. The higher the they are sad, down, or feel blue. Direct addition of all items
score, the greater is the tendency to use thought suppression. is necessary to obtain the total score. The higher the score,
The Spanish version of the questionnaire by González, Av- the higher is the level of rumination. The Spanish adaptation
ero, Rovella, and Cubas (2008) identified a two-factor struc- by Ricarte et al. (2018) exhibited excellent internal consisten-
ture distinguishing between unwanted intrusive thoughts (α = .87) cy in its validation study (α = .93) and in the present work (α
and actions of distraction and thought suppression (α = .80). Follow- = .89).
ing the approach of Dugas, Gagnon, Ladouceur, and Free-
ston (1998), the present study uses only the thought suppres- The Penn State Worry Questionnaire
sion factor (α = .86).
The Penn State Worry Questionnaire (PSWQ; Meyer,
Coping Response Inventory for Adults Miller, Metzger, & Brockovec, 1990; Spanish adaptation by
To evaluate coping strategies, we used the Spanish adap- Sandín, Chorot, Valiente, & Lostao, 2009) measures the gen-
tation of the Coping Response Inventory for Adults (CRI-A; eral tendency of an individual to worry, or trait worry. It
Moos, 1993) by Kirchneer and Forns (2010). The inventory comprises 16 items scored on a 5-point interval scale, rang-
has two parts. In the first part, the participant describes an ing from 1 (not at all typical of me) to 5 (very typical of me).
important problem or stressful situation they have experi- The Spanish version used showed good internal consistency
enced in the last year, measuring the level of stress and the and test-retest reliability. In the study sample, the PSWQ had
degree of perceived control, and responds to 10 questions an internal consistency of α = .79.
that measure the participant’s evaluation of the problem de- Procedure
scribed. The second part comprises a 48-item self-report
scale which assesses coping responses to stressful life experi- Translation of the CAQ
ences. The criteria are: no never; once or twice; quite often; yes, al-
most always. The scale identifies four approach strategies and Following the guidelines for translating psychological
four avoidance strategies. Approach strategies: 1) Logical analy- tests (Hambleton, 2005; International Test Commission,
sis (LA): cognitive attempts to prepare mentally for a stress- 2016), a preliminary forward English to Spanish translation
or and its consequences; 2) Positive reappraisal (PR): cogni- of the scale was made by two of the native Spanish authors,
tive attempts to restructure a problem in a positive way while who are completely bilingual and have experience in research
accepting the reality of the situation; 3) Seeking guidance and on coping strategies and the adaptation of psychological as-
support (SGS): behavioral attempts to seek information, sessment instruments. Subsequently, with special emphasis
guidance, or support; 4) Problem solving (PS): behavioral at- on the conceptual and cultural equivalence of the items, a
tempts to take action to deal directly with the problem. qualified native English translator, familiarized with psychol-
Avoidance strategies: 5) Cognitive avoidance (CA): cognitive at- ogy but blind to the original scale, carried out a back transla-
tempts to avoid realistically thinking about the problem; 6) tion. Lastly, to refine the instructions and all the items, the
Resigned acceptance (RA): cognitive attempts to react to the definitive version of the instrument was revised by bilingual
problem by accepting it; 7) Seeking alternative rewards translators, the authors of the present study and researchers
(SAR): behavioral attempts to cope by finding substitute ac- from our department.
tivities or creating new sources of satisfaction; and 8) Emo-
tional discharge (DE): behavioral attempts to reduce tension Data collection
by expressing negative feelings. The Spanish adaptation of
the scale presents adequate psychometric properties and va- Informed consent was obtained from all individual par-
lidity (Moos, 2010). The internal consistency of the Spanish ticipants included in the study. The study data were collected
version of CRI-A yields Cronbach’s alpha values ranging in two phases. First, data were obtained from 147 partici-
from .50 to .70 for each of the subscales. In the present pants to analyze the factor structure and psychometric prop-
study, the cognitive avoidance subscale exhibited an internal erties of the Spanish adaptation of the CAQ, which, hereon
consistency of α = .63. in, we will call Cuestionario de Evitación Cognitiva (CEC). Sec-
ond, we decided to increase the sample with the aim of
Short Depressive Rumination Scale achieving a better empirical fit of the data to the initially
proposed theoretical model. A further 467 participants were
The Short Depressive Rumination Scale (SDRS; Raes, then added to the measures of the CEC. That is, validity
Hermans, Williams, & Eelen, 2007; Spanish adaptation by measures were not recorded for the increased sample.

anales de psicología / annals of psychology, 2020, vol. 36, nº 3 (october)

460 Jose M. Latorre et al.

First, we held informational meetings with the manage- avoidance (CRI-A). For the divergent validity, we analyzed
ment teams and the faculty officers of the collaborating or- the relation between the CEC and the two coping strategies
ganizations. Once permission to conduct the research had from the CRI-A (logical analysis and positive reappraisal).
been received, data collection commenced. The data on the Finally, hierarchical regression analysis was used to study the
university students was collected in group format during contribution of the CEC in predicting worry.
class hours. The other assessments were administered in
rooms at our university, individually or in groups, according Results
to participant availability. Data collection was conducted in a
single session. In the session, we explained the aims of the Preliminary analyses
study, responded to any questions and collected the partici-
pants’ informed consent before beginning the tests. It was All the study variables were analyzed for multivariate
made clear that the individuals invited to participate were do- outliers, univariate outliers, and normality of the distribution.
ing so voluntarily and that they could answer the questions A total of 26 multivariate outliers were identified using the
on the data collection form partially or completely and could robust Mahalanobis distance (Rousseeuw & Leroy, 1987),
leave the room at any time they wished. The data were col- and were eliminated from the dataset. For the univariate out-
lected by four examiners with experience in validating scales. liers, the typified scores were calculated. In accordance with
the recommendations of Tabachnick and Fidell (2001), val-
Data analysis ues falling 3.29 standard deviations (p < .001, two-tailed test)
either above or below the mean were considered atypical.
Data analysis was conducted using IBM SPSS Statistics Following this criterion, no atypical univariate values were
24.0 and AMOS-23 (Arbuckle, 2014). First, the normality of found. Finally, critical ratios for skewness and kurtosis were
the data was verified, outliers were detected, and descriptive higher than 1.96, for both univariate and multivariate nor-
analyses were conducted. Second, CFA was used to evaluate mality. Thus, the criterion of normal distribution was not
the factor structure of the CEC and the internal consistency fulfilled. Table 1 shows the descriptive analyses for the 25
was verified by Cronbach’s alpha coefficient. Third, the con- items in the CEC and the corrected correlation coefficients
vergent validity of the questionnaire was assessed using Pear- between the items and the total questionnaire, whose values
son's correlation analysis to examine the correlations be- ranged between rcorr = .39 and rcorr = .75. Table 2 shows orig-
tween the CEC and the measures of worry (PSWQ), rumina- inal items of the CAQ.
tion (SDRS), thought suppression (WBSI) and cognitive
Table 1. Descriptive statistics and corrected item-total correlations of the CEC (N = 614).
No. Item M SD rcorr
1 Hay cosas en las que preferiría no pensar. 3.22 1.19 .53
2 Evito ciertas situaciones que me llevan a prestar atención a asuntos en los que no quiero pensar. 2.77 1.08 .62
3 Sustituyo las imágenes mentales amenazadoras por cosas que me digo a mí mismo. 2.47 1.14 .45
4 Pienso en cosas que tienen que ver conmigo como si le estuvieran ocurriendo a otro. 1.91 1.07 .40
5 Tengo pensamientos que intento evitar. 2.85 1.17 .68
6 Intento no pensar en los aspectos más molestos de algunas situaciones para así no tener demasiado miedo. 2.56 1.13 .63
7 A veces evito ciertos objetos que me pueden provocar pensamientos molestos. 2.15 1.14 .64
8 Me distraigo para evitar pensar en ciertos temas que me inquietan. 2.79 1.15 .67
9 Evito a las personas que me hacen pensar en cosas en las que no quiero pensar. 2.59 1.29 .59
10 A menudo hago cosas para así evitar mis pensamientos. 2.51 1.14 .67
11 Pienso en detalles triviales para no tener que pensar en los asuntos importantes que me preocupan. 2.03 0.98 .61
12 A veces me meto de lleno en una actividad para así no tener que pensar en ciertas cosas. 2.73 1.16 .63
13 Para evitar pensar en temas que me perturban me obligo a pensar en otra cosa. 2.56 1.11 .70
14 Hay cosas en las que intento no pensar. 3.05 1.15 .72
Me repito a mí mismo cosas en la cabeza para no tener que visualizar los escenarios (una serie de imágenes
15 2.07 1.08 .65
mentales) que me dan miedo.
16 A veces evito los lugares que me hacen pensar en cosas en las que preferiría no pensar. 2.18 1.12 .62
Pienso en acontecimientos del pasado para no pensar en acontecimientos del futuro que me hacen sentir in-
17 1.83 1.08 .49
seguro.
18 Evito las acciones que me recuerdan las cosas en las que no quiero pensar. 2.27 1.05 .75
Cuando me vienen imágenes mentales que me molestan, me digo cosas mentalmente para sustituir a las imá-
19 2.37 1.12 .58
genes.
20 Pienso en muchas cosas de poca importancia para así no tener que pensar en asuntos más importantes. 1.88 0.96 .55
21 Hay veces que me mantengo ocupado solo para evitar que determinados pensamientos me vengan a la mente. 2.51 1.16 .69
22 Evito las situaciones en las que tengo que tratar a personas que me hacen pensar en cosas desagradables. 2.47 1.17 .60
Para evitar que se formen en mi mente imágenes de acontecimientos molestos, intento describir los aconteci-
23 2.20 1.08 .57
mientos a través de un monólogo interno (cosas que me digo a mí mismo).

anales de psicología / annals of psychology, 2020, vol. 36, nº 3 (october)

 Cognitive Avoidance Questionnaire: Factor structure and psychometric properties 461

No. Item M SD rcorr

Alejo de mi mente las imágenes mentales relacionadas con una situación amenazadora, intentando utilizar un
24 2.23 1.05 .65
monólogo interno para describir la situación.
25 Pienso en las cosas que preocupan a otros en lugar de pensar en mis propias preocupaciones. 2.05 1.08 .43
Note. CEC = Cuestionario de Evitación Cognitiva; rcorr = corrected item-total correlations.

Table 2. Original items of the CAQ (Sexton & Dugas, 2008).

No. Item
1 There are things that I would rather not think about.
2 I avoid certain situations that lead me to pay attention to things I do not want to think about.
3 I replace threatening mental images with things I say to myself in my mind.
4 I think about things that concern me as if they were occurring to someone else.
5 I have thoughts that I try to avoid.
6 I try not to think about the most upsetting aspects of some situations so as not to be too afraid.
7 I sometimes avoid objects that can trigger upsetting thoughts.
8 I distract myself to avoid thinking about certain disturbing subjects.
9 I avoid people who make me think about things that I do not want to think about.
10 I often do things to distract myself from my thoughts.
11 I think about trivial details so as not to think about important subjects that worry me.
12 Sometimes I throw myself into an activity so as not to think about certain things.
13 To avoid thinking about subjects that upset me. I force myself to think about something else.
14 There are things I try not to think about.
15 I keep saying things to myself in my head to avoid visualizing scenarios (a series of mental images) that frighten me.
16 Sometimes I avoid places that make me think about things I would prefer not to think about.
17 I think about past events so as not to think about future events that make me feel insecure.
18 I avoid actions that remind me of things I do not want to think about.
19 When I have mental images that are upsetting. I say things to myself in my head to replace the images.
20 I think about many little things so as not to think about more important matters.
21 Sometimes I keep myself occupied just to prevent thoughts from popping up in my mind.
22 I avoid situations that involve people who make me think about unpleasant things.
Rather than having images of upsetting events form in my mind. I try to describe the events using an internal monologue (things that
23
I say to myself in my head).
24 I push away the mental images related to a threatening situation by trying to describe the situation using an internal monologue.
25 I think about things that are worrying other people rather than thinking about my own worries.
Note. CAQ = Cognitive Avoidance Questionnaire.

Psychometric properties of the CEC ered optimal, although values up to .08 are acceptable (Byr-
ne, 2001). With regard to χ2 (CMIN), although a non-
Confirmatory factor analysis significant value indicates the best fit, this statistic is influ-
enced by sample size and thus some authors suggest the use
As multivariate normality was not satisfied, the variables of χ2/degrees of freedom (CMIN/DF) as the most appro-
were ordinal, and the sample was large enough (> 200), the priate measure (Byrne, 2001). CMIN/DF < 3 indicates an
parameters were estimated using the asymptotic distribution- acceptable fit between the hypothetical model and sample
free method, namely, weighted least squares (Bollen, 1989; data (Kline, 1998, 2011) and CMIN/DF< 5 indicates a rea-
Kline, 1998, 2011). For the CFA, the variance of each factor sonable fit (Marsh & Hocevar, 1985). Additionally, Akaike
was set at 1.0, and hence the loading of each CEC item Information Criterion (AIC) is used to compare different
could be freely estimated. The indicators loaded on only one models; lower scores indicate a better fitting model (Akaike,
factor and the errors of measurement were not included in 1987). We conducted four models to examine the best fit be-
the correlations in order to give greater accuracy to the valid- tween the theoretical structure and the empirical data. First,
ity of the indicator (Anderson & Gerbing, 1988). As regards we replicated the five-factor structure of the CAQ (Sexton &
the estimators, the Comparative Fit Index (CFI), the Good- Dugas, 2008). Subsequently, the first model was opposed to
ness of Fit Index (GFI), the Incremental Fit Index (IFI) and other possible models to explore the existence of a general
the Root Mean Square Error of Approximation (RMSEA) factor. Results of testing the four models are summarized in
were used to evaluate the goodness of fit. The values of Table 3.
these statistics (CFI, GFI, and IFI) varied between 0 y 1, Model 1: Five-factor model. The model specification was
where 1 indicates a perfect fit. Values above .90 suggest a based on the 25-item five-factor structure proposed both in
satisfactory fit between the theoretical theories and empirical the original French version (QEC), and the adaptation in
data, and values of .95 and above, an optimal fit (Hu & English (CAQ). The fit indices are generally at or close to
Bentler, 1999). For RMSEA, values close to .05 are consid- acceptable ranges indicating an acceptable fit of the five-

anales de psicología / annals of psychology, 2020, vol. 36, nº 3 (october)

462 Jose M. Latorre et al.

factor model. The factor loadings were above .45. (Figure 1). sion, Thought Substitution, Distraction, Avoidance of
All five CEC factors were robust interrelated (> .50; Cohen, Threatening Stimuli, and Transformation of Images into
1988). Thoughts) and one second-order factor (CECtotal). The mod-
Model 2: Unidimensional model. A one-factor CFA was con- el showed a good fit. The factor loadings were above .53.
ducted, which assumed that the covariance among the 25 (Figure 2).
items of the CEC is due to a single common factor. Howev- Model 4: Bi-factor model with a general factor and five group fac-
er, a general factor showed a poor fit to the observed data. tors. Each individual item was specified to load directly on
The factor loadings ranged between .24 and .74. both its specific subscale (or factor) and on a general factor
Model 3: Five first-order factors and one second-order factor. In that is related to all items in a multidimensional measure.
this model the intercorrelations among first-order factors Unfortunately, the results for bi-factor model were not satis-
form a system of interdependence that is itself important in factory.
measuring the construct. Each factor and second-order fac- In short, the model 1 and 3 were the best fit. As the sta-
tor are necessary in capturing the nature of the construct tistics of both models were acceptable, we computed AIC.
domain. The second-order factor of the CEC exists but can- The AIC value for the five-factor model was 1076.72, and
not be directly measured by indicator variables. It can only the AIC value for the five first-order factors and one sec-
be inferred from the first-order factors, which in turn are ond-order factor was 630.53. According to these results, the
measured by their respective indicator variables. A model model 3 showed the best fit to the observed data.
was tested with five first-order factors (Thought Suppres-

Table 3. Confirmatory factor analyses results (N = 614).

Model CMIN (DF) CMIN/DF CFI IFI GFI RMSEA AIC
1. Five-factor 956.72* 3.61 .91 .91 .90 .06 1076.72
2. One-factor 942.29* 3.54 .69 .68 .86 .06 1060.29
3. Five first-order factors and one second-order factor 482.53* 1.92 .90 .90 .93 .04 630.53
4. Bi-factor model with a general factor and five group factors 852.85* 3.48 .72 .73 .87 .06 1012.86
Note. *p < .001.

Figure 1. Factor loading of CFA: Five-factor model.

Note. F1 = Thought Suppression subscale; F2 = Thought Substitution subscale; F3 = Distraction subscale; F4 = Avoidance of Threatening Stimuli subscale;
and F5 = Transformation of Images into Thoughts subscale.
All ps < .001.

anales de psicología / annals of psychology, 2020, vol. 36, nº 3 (october)

 Cognitive Avoidance Questionnaire: Factor structure and psychometric properties 463

Figure 2. Factor loading of CFA: Second-factor model.

Note. F1 = Thought Suppression subscale; F2 = Thought Substitution subscale; F3 = Distraction subscale; F4 = Avoidance of Threatening Stimuli subscale;
and F5 = Transformation of Images into Thoughts subscale; CECtotal = Cuestionario de Evitación Cognitiva total.
All ps < .001.

Analysis of internal consistency Thought Suppression (α = .85); Thought Substitution (α =

.74); Distraction (α = .87); Avoidance of Threatening Stimuli
Cronbach’s alpha coefficient was used to analyze the in- (α = .85); and Transformation of Images into Thoughts (α =
ternal consistency of the CEC and its five subscales. The in- .83). Additionally, Table 4 shows the correlations between
ternal consistency of the CECtotal was excellent (α = .94). empirical scores of the CEC subscales.
Cronbach’s alpha for the five subscales were as follows:

Table 4. Correlations between empirical scores of the CEC subscales and descriptive statistics.
1 2 3 4 5 6
1. Thought Suppression -
2. Thought Substitution .51 -
3. Distraction subscale .71 .60 -
4. Avoidance of Threatening Stimuli .67 .59 .67 -
5. Transformation of Images into Thoughts .60 .55 .62 .59 -
6. CECtotal .85 .76 .88 .85 .81 -
Mean 14.45 9.69 13.09 11.66 11.32 60.23
SD 4.54 3.63 4.64 4.57 4.21 18.02
Rank 5-25 5-25 5-25 5-25 5-25 25-125
Note. CEC = Cuestionario de Evitación Cognitiva.
All correlation indices were significant ps < .01.

Construct validity of the CEC worry, rumination, thought suppression and cognitive avoid-
ance in the CRI-A. For the discriminant validity, we used the
To analyze the convergent validity of the CEC, we ana- cognitive approach strategies in the CRI-A (logical analysis
lyzed its relation with other measures assessing theoretically and positive reappraisal).
similar constructs. Thus, we examined the correlations be-
tween the CEC and its five subscales and the measures of

anales de psicología / annals of psychology, 2020, vol. 36, nº 3 (october)

464 Jose M. Latorre et al.

Correlation with a measure of worry .01); and transformation of images into thoughts (r = .58, p
<. 01).
A moderate correlation was found between the CECtotal
and the PSWQ (r = .41, p <.01). The correlations of the five Correlation with coping responses
subscales of the CEC with the PSWQ were slightly lower
than those with the total scale: thought suppression (r = .35, The CECtotal was moderately correlated (r = .48, p < .01)
p < .01); thought substitution (r = .37, p < .01); distraction (r with the cognitive avoidance subscale from the CRI-A. This
= .37, p < .01); avoidance of threatening stimuli (r = .29, p < finding supports the convergent validity of the CEC with
.01); and transformation of images into thoughts (r = .36, p another cognitive avoidance scale. As regards discriminant
< .01). validity, the correlations with the coping style strategies from
the CRI-A were non-significant: logical analysis (r = .17, p >
Correlation with a measure of rumination .05) and positive reappraisal (r = .06, p > .05).

The measure of rumination considered was the Visual Hierarchical regression

Analog Rumination Scale (VARS). It was found to be mod-
erately and positively associated with the CEC (r = .37, p To maximize knowledge of the load of each variable and
<.01). The analysis with the five CEC subscales yielded the study the incremental validity of the CEC with respect to
following results: thought suppression (r = .35, p < .01); worry, we conducted a hierarchical regression analysis, using
thought substitution (r = .25, p < .01); distraction (r = .35, p the measure of worry (PSWQ) as dependent variable. At the
< .01); avoidance of threatening stimuli (r = .31, p < .01); first step, the cognitive avoidance scale from the CRI-A was
and transformation of images into thoughts (r = .27, p < entered, followed by the thought suppression variable meas-
.01). These correlations were either moderate or low, with ured by the WBSI, and, finally, the CECtotal. The results re-
the highest correlation being that with the CECtotal. vealed that the thought suppression strategy was the strong-
est predictor of worry. However, the CEC was found to
Correlation with a measure of thought suppression have very little weight in the prediction of this variable. The
results, shown in Table 5, showed that at the second step the
The WBSI yielded positive correlations ranging from thought suppression measure was a significantly strong pre-
moderate to high for both the total CEC (r = .72, p < .01) dictor of worry, with the predictive power of the cognitive
and each of the five factors: thought suppression (r = .67, p avoidance scale from the CRI-A being lower, although the
< .01); thought suppression (r = .47, p < .01); distraction (r variable that least predicted worry was the CECtotal.
= .71, p < .01); avoidance of threatening stimuli (r = .56, p <

Table 5. Hierarchical regression model (N = 147).

Dependent variable Step Predictor ΔR² ΔF B S.E. B β
1 CRI-A, EC .029 3.91* ‐.16 .28 ‐.04
PSWQ 2 WBSI .228 40.4*** .44*** .09 .49
3 CEC .001 .22 .03 .07 .05
Note. PSWQ = Penn State Worry Questionnaire; CRI-A, EC = Cognitive avoidance subscale, Coping Response Inventory for Adults; WBSI = White Bear
Suppression Inventory; CEC = Cuestionario de Evitación Cognitiva.
*p < .05; ***p < .001.

Discussion er, when we opposed the five-factor model to other possible

models to examine the existence of a general factor, we
The CAQ assesses five forms of cognitive avoidance related found that the second-order model (i.e., five first-order fac-
to worry and GAD (e.g., Dugas et al., 2007; Robichaud, Du- tors and one second-order factor) exhibited the best fit be-
gas, & Conway, 2003). The measure has not been studied in tween the theoretical structure and the empirical data in the
samples of individuals with anxiety, although the psychomet- Spanish sample. Moreover, both the CECtotal scale and its
ric properties found in non-clinical samples have been ade- subscales demonstrated good to excellent internal consisten-
quate, and thus it can be considered a useful and reliable in- cy. The CFA results yielded satisfactory goodness of fit for
strument to assess worry-related cognitive avoidance strate- the CFI, IFI, GFI, CMIN/df and RMSEA. Nonetheless, it
gies. Consequently, the aim of the present study was to ana- should be noted that our data did not follow a normal distri-
lyze the factor structure and the psychometric properties of bution and the indices were not wholly comparable with
the Spanish translation of the CAQ in a non-clinical sample. those of the reference study, as our structural equation mod-
According to previous researchs (Gosselin et al., 2002; eling program was different from that used by Sexton and
Sexton & Dugas 2008), the 25-item five-factor structure Dugas (2008). The factor loadings for each of the items on
found in the present study showed an acceptable fit. Howev- the CEQ were similar to those for the CAQ. The lower

anales de psicología / annals of psychology, 2020, vol. 36, nº 3 (october)

 Cognitive Avoidance Questionnaire: Factor structure and psychometric properties 465

overall goodness of fit of the previous version was attributed This work has a number of limitations that should be
to some of the items being loaded in more than one factor. considered. First, similarly to the English version, the study
However, as previously mentioned, the goodness of fit of sample consisted entirely of participants without diagnosis of
our model was adequate. GAD or any other anxiety disorder. Thus, it would be neces-
To verify the convergent validity, we calculated the cor- sary to analyze the factor structure and psychometric proper-
relations between the CEC and the PSWQ worry measure, ties of the CEC in clinical samples to determine whether the
the two cognitive avoidance subscales from the CRI-A (cog- instrument is equivalent in other populations. Second, the
nitive avoidance) and the thought suppression factor from data on validity were only recorded in a sub-sample. A larger
the WBSI. In addition, the decision to include the construct number of participants would be needed to corroborate
of rumination was motivated by the parallels established be- these criteria and substantially enhance the quality of our re-
tween this measure and worry, and the influence of cognitive search. Third, the study groups were not equivalent in size,
avoidance in this process (Dickson et al., 2012). This trig- given the majority were young adults. It would be useful to
gered our interest in making a first approach to the relation increase the number of middle-aged persons and older adults
between rumination and cognitive avoidance using the CEC, with the aim of conducting multi-group analyses to deter-
for which results were favorable given that they presented a mine whether the CEC presents factor invariance across ag-
significant correlation. This finding corroborates similar evi- es. Fourth, our results were not as expected with regard to
dence provided by Moulds, Kandris, Starr, and Wong (2007), the contribution of the CEC in explaining worry. Thus,
who conceptualized rumination as a cognitive avoidance more in-depth analysis of this issue would constitute an in-
strategy. Similar approaches have been developed, with a teresting future research line. Finally, as occurred with the
significant impact on clinical practice. For example, it has validation of the CAQ, although a measure of worry was
been suggested that rumination may serve to avoid painful used to analyze the convergent validity of the questionnaire,
aspects of loss, thereby hampering adjustment to bereave- its association with other processes related to worry was not
ment (Eisma & Stroebe, 2017), while Aldao et al. (2010) analyzed, which was, however, done in the French version
found that avoidance, rumination and suppression were (Gosselin et al., 2002), nor was the CEC’s relation to other
among the strongest predictors of psychopathology symp- anxiety disorder symptoms examined. It would be useful to
toms. Finally, the discriminant validity of the CEC was include these additional measures in future studies.
demonstrated through its correlations with the measures of To conclude, the CEC has been shown to be a useful in-
cognitive approach from the CRI-A (logical analysis and pos- strument to assess the tendency to use cognitive avoidance
itive reappraisal). From the perspective of the classification as a strategy to deal with threatening intrusive thoughts. The
of coping strategies, these results were as expected, given present study identified five first-order factors and one sec-
that logical analysis and positive reappraisal are considered to ond-order factor whose goodness-of-fit statistics were satis-
be approach styles, understood as cognitive or behavioral ef- factory. That is to say, this model showed that the responses
forts focused on handling a stressor, and thus potentially to the measurement of cognitive avoidance could be ex-
opposed to avoidance strategies (Moos, 1993). Moreover, plained by five first order factors (Thought Suppression,
although cognitive avoidance strategies have been associated Thought Substitution, Distraction, Avoidance of Threaten-
with psychopathology (e.g., Barajas et al., 2017: Hayes, 2016; ing Stimuli, and Transformation of Images into Thoughts)
Schäfer et al., 2017; Struijs et al., 2018), it should be taken in- and there was one second-order factor (CECtotal) that under-
to account that their use depends, among other elements, on lies the five first-order factors. The total scale and subscales
the types of the stressors and individual and generational dif- showed good to excellent internal consistency. Moreover,
ferences (e.g., Chen, Peng, Xu, & O´Brain, 2018; Nieto et al., the questionnaire presented adequate convergent and dis-
2020). criminant validity. Thus, it can be considered the results re-
With regard to the hierarchical regression analysis con- flect good preliminary data on the questionnaire. Our find-
ducted to predict worry, the results were not as expected, ings should serve as a starting point for subsequent, more
given that CEC barely predicted the tendency toward worry. exhaustive studies, which are needed in view of the implica-
This was in contrast to the results of the study on the Eng- tions for clinical practice of the use of cognitive avoidance
lish version of the instrument in which CAQ was found to strategies in anxiety disorders, and more particularly, in
be a significant predictor of worry. However, coinciding with GAD.
the study validating the English version, the measure of
thought suppression, the WBSI, was the most robust predic- Funding: This work was partially supported by Spanish Minis-
tor of worry. terio de Ciencia, Innovación y Universidades, Agencia Estatal de
Investigación (AEI)/ European Regional Development Fund
(FEDER, UE) under DPI2016-80894-R grant.

anales de psicología / annals of psychology, 2020, vol. 36, nº 3 (october)

466 Jose M. Latorre et al.

References
Akaike, H. (1987). Factor analysis and AIC. Psychometrika, 52, 317–332. Gosselin, P., Langlois, F., Freeston, M. H., Ladouceur, R., Dugas, M. J., &
doi:10.1007/BF02294359 Pelletier, O. (2002). Le Questionnaire d’e´vitement cognitif (QEC):
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation De´veloppement et validation aupre`s d’adultes et d’adolescents [The
strategies across psychopathology: A meta-analytic review. Clinical Psy- CognitiveAvoidance Questionnaire (CAQ): Development and valida-
chology Review, 30, 217–237. doi:10.1016/j. cpr.2009.11.004 tion among adult and adolescent samples]. Journal de The´rapie Comporte-
American Psychiatric Association. (2013). Diagnostic and statistical manual of mentale et Cognitive, 12, 24–37.
mental disorders: DSM-5 (Fifth Edit). Washington, DC: American Psychi- Hambleton, R. K. (2005). Issues, designs and technical guidelines for adapt-
atric Association. ing tests into multiple languages and cultures. In R. K. Hambleton, P.
Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in F. Merenda, & S. D. Spielberger (Eds.), Adapting educational and psychologi-
practice: A review and recommended two-step approach. Psychological cal tests for cross-cultural assessment (pp. 3-38). Mahwah, NJ: Lawrence Erl-
Bulletin, 103, 411-423. doi: 10.1037/0033-2909.103.3.411 baum Associates.
Arbuckle, J. L. (2014). AMOS-23. Chicago, IL: IBM SPSS. Hayes, S. C. (2016). Acceptance and commitment therapy, relational frame
Barajas, S., Garra, L., & Ros, L. (2017). Avoidance in anxiety and depres- theory, and the third wave of behavioral and cognitive therapies - re-
sion: Adaptation of the Cognitive-Behavioral Avoidance Scale in a published article. Behavior Therapy, 47, 869-885. doi:
Spanish sample. The Spanish Journal of Psychology, 20, 1-11. doi: 10.1016/j.beth.2016.11.006
10.1017/sjp.2017.16 Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K.
Behar, E., DiMarco, I. D., Hekler, E. B., Mohlman, J., Staples, A. M., & (1996). Experimental avoidance and behavioral disorders: a functional
Dobrow, I. (2009). Current theoretical models of generalized anxiety dimensional approach to diagnosis and treatment. Journal of Consulting
disorder (GAD): Conceptual review and treatment implications. Journal and Clinical Psychology, 64, 1152-1168. doi:10.1037/0022-006X.64.6.1152
of Anxiety Disorders, 23, 1011–1023. doi: 10.1016/j.janxdis.2009.07.006 Hearn, C. S., Donovan, C. L., Spence, S. H., & March, S. (2018). Do worry
Bollen, K. A. (1989). Structural equations with latent variables. New York, NY: and its associated cognitive variables alter following CBT treatment in a
Wiley. youth population with Social Anxiety Disorder? Results from a ran-
Borkovec, T. D., Alcaine, O. M., & Behar, E. (2004). Avoidance theory of domized controlled trial. Journal of Anxiety Disorders, 53, 46-57.
worry and generalized anxiety disorder. Generalized anxiety disorder: doi:10.1016/j.janxdis.2017.11.005
Advances in research and practice (pp. 77–108). New York, NY: Guil- Hirsch, C. R., Perman, G., Hayes, S., Eagleson, C., & Mathews, A. (2015).
ford. Delineating the role of negative verbal thinking in promoting worry,
Borkovec, T. D., Robinson, E., Pruzinsky, T., & DePree, J. A. (1983). Pre- perceived threat, and anxiety. Clinical Psychological Science, 3, 637-647. doi:
liminary exploration of worry: Some characteristics and processes. Be- 10.1177/2167702615577349
haviour Research and Therapy, 21, 9–16. doi:10.1016/0005-7967(83)90121- Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indices in covariance
3 structure analysis: Conventional criteria versus new alternatives. Struc-
Bryne, B. M. (2001). Structural equation modeling with AMOS: Basic concepts, ap- tural Equation Modeling, 6, 1-55. doi:10.1080/10705519909540118
plications, and programming. Mahwah, NJ: Lawrence Erlbaum Associates. International Test Commission. (2016). The ITC Guidelines for translating and
Capobianco, L., Morris, J. A., & Wells, A. (2018): Worry and rumination: do adapting tests (Second edition). Retrieved from:
they prolong physiological and affective recovery from stress? Anxiety, https://www.intestcom.org/
Stress, & Coping, 31, 291-303. doi:10.1080/10615806.2018.1438723 Kirchner, T., & Forns, M. (2010). Spanish adaptation of Coping Responses Inven-
Chen, Y., Peng, Y., Xu, H., & O´Brain, W. H. (2018). Age differences in tory-Adult. Madrid: TEA Ediciones.
stress and coping: Problem-focused strategies mediate the relationship Kline, R. B. (2011). Principles and practice of structural equation modeling (3ª Ed.).
between age and positive affect. The International Journal of Aging and New York: The Guilford Press.
Human Development, 86, 347-363. doi: 10.1177/0091415017720890 Lobo, A., Saz, P., Marcos, G., & Zaracemp, G. T. (2002). Spanish version of the
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. (2nd ed) Hills- Mini-Mental Cognitive Test (MEC). Madrid: TEA Ediciones.
dale, NJ: Lawrence Erlbaum. Marsh, H. W., & Hocevar, D. (1985). Application of confirmatory factor
Dickson, K. S., Ciesla, J. A., & Reilly, L. C. (2012). Rumination, worry, cog- analysis to the study of self-concept: first-and higher order factor mod-
nitive avoidance, and behavioral avoidance. Examination of temporal els and their invariance across groups. Psychological Bulletin, 97, 562–582.
effects. Behaviour Therapy, 43, 629-640. doi: 10.1016/j.beth.2011.11.002 doi: 10.1037/0033-2909.97.3.562
Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, H. (1998). General- Matthews G., & Wells A. (2004). Rumination, depression and metacogni-
ized anxiety disorder: A preliminary test of a conceptual model. Behav- tion: The S-REF Model. In C. Papageorgiou & A. Wells (Eds.), Depres-
iour Research and Therapy, 36, 215–226. doi: 10.1016/S0005- sive rumination. Nature, theory and treatment (pp. 125–151). Chichester, UK:
7967(97)00070-3 John Wiley & Sons.
Dugas, M. J., Savard, P., Gaudet, A., Turcotte, J., Laugesen, N., Ro- Meyer, T. J., Miller, M. L., Metzger, R. L., y Brokovec, T. D. (1990). Devel-
bichaud, M., Francis, K., & Koerner, N. (2007). Can the components opment and validation of the Penn State Wory Questionnaire. Behaviour
of a cognitive model predict the severity of generalized anxiety disor- Research and Therapy, 28, 487-‐495. doi: 10.1016/0005-‐7967(90)90135-6
der? Behavior Therapy, 38, 169-178. doi: 10.1016/j.beth.2006.07.002 Moos, R. (1993). Coping Responses Inventory: CRI Adult-Form. Odessa, Ukraine:
Eifert, G. H., & Forsyth, J. P. (2005). Acceptance and commitment therapy for anx- Psychological Assessment Resources. Inc.
iety disorders: A practitioner’s treatment guide to using mindfulness, acceptance and Moulds, M. L., Kandris, E., Starr, S., & Wong, A. C. M. (2007). The rela-
values-based behavior change strategies. Oakland, CA: New Harbinger Publi- tionship between rumination, avoidance and depression in a non-
cations. clinical sample. Behaviour Research and Therapy, 25, 251–261. doi:
Eisma, M., & Stroebe, M. (2017). Rumination following bereavement: An 10.1016/j.brat.2006.03.003
overview. Newman, M. G., Llera, S. J., Erickson, T. M., Przeworski, A., & Castonguay,
Bereavement Care, 36, 58-64. doi: 10.1080/02682621.2017.1349291 L. G. (2013). Worry and Generalized Anxiety Disorder: A review and
González, M., Avero, P., Rovella, A. T., & Cubas, R. (2008). Structural va- theoretical synthesis of evidence on nature, etiology, mechanisms, and
lidity and reliability of the Spanish version of the White Bear Suppres- treatment. Annual Review of Clinical Psychology, 9, 275-297. doi:
sion Inventory (WBSI) in a sample of the general Spanish population. 10.1146/annurev-clinpsy-050212-185544
Spanish Journal of Psychology, 11, 650-659. Nieto, M., Romero, D., Ros, L., Zabala, C., Martínez, M., Ricarte, J. J., Se-
Goodwin, H., Yiend, J., & Hirsch, C. (2017). Generalized anxiety disorder rrano, J. P., & Latorre, J. M. (2020). Differences in coping strategies be-
worry and attention to threat: A systematic review. Clinical Psychology Re- tween young and older adults: The role of executive functions. The In-
view, 54, 107-122. doi: 10.1016/j.cpr.2017.03.006 ternational Journal of Aging and Human Development. doi:
10.1177/0091415018822040

anales de psicología / annals of psychology, 2020, vol. 36, nº 3 (october)

 Cognitive Avoidance Questionnaire: Factor structure and psychometric properties 467

Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders propiedades psicométricas [Spanish validation of the PSWQ concern
and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology, questionnaire: factor structure and psychometric properties]. Revista de
109, 504–511. doi:10.1037/0021-843X.109.3.504 Psicopatología y Psicología Clínica, 14, 107-122. doi:
Østefjells, T., Melle, I., Aminoff, S. R., Hellvin, T., Hagen, R., Lagerberg T. 10.5944/rppc.vol.14.num.2.2009.4070
V., … Røssberg, J. I. (2017). An exploration of metacognitive beliefs Schäfer, J. Ö., Naumman, E., Holmes, E. A., Tuschen-Caffier, B., & Sam-
and thought control strategies in bipolar disorder. Comprehensive Psychia- son, A. C. (2017). Emotion regulation strategies in depressive and anxi-
try, 73, 84-92. doi: 10.1016/j.comppsych.2016.11.008 ety symptoms in youth: A meta-analytic review. Journal of Youth and Ado-
Raes, F., Hermans, D., Williams, J. M. G., Bijttebier, P., & Eelen, P. (2007). lescence, 46, 261-276. doi: 10.1007/s10964-016-0585-0
A “Triple W” model of rumination on sadness: Why am I feeling sad, Segerstrom S. C., Tsao J. C. I., Alden L. E., & Craske M. G. (2000). Worry
what’s the meaning of my sadness, and wish I could stop thinking and rumination: Repetitive thought as a concomitant and predictor of
about my sadness (but I can’t). Cognitive Therapy and Research, 32, 526– negative mood. Cognitive Therapy and Research, 24, 671–688. doi:
541. doi:10.1007/s10608-007-9137-y 10.1023/A:1005587311498
Raes, F., Hermans, D., Williams, J. M. G., & Eelen, P. (2007). A sentence Servatius, R. J. (2016). Avoidance: From basic science to psychopathology.
completion procedure as an alternative to the Autobiographical Frontiers in Behavioral Neuroscience, 10, 15. doi: 10.3389/fnbeh.2016.00015
Memory Test for assessing overgeneral memory in non-clinical popula- Sexton, K. A., & Dugas, M. J. (2008). The Cognitive Avoidance Question-
tions. Memory, 15, 495–507. doi: 10.1080/09658210701390982 naire: Validation of de English translation. Journal of Anxiety Disorders,
Rousseeuw P. J., & Leroy A. M. (1987). Robust regression and outlier detection. 22, 335-370. doi: 10.1016/j.janxdis.2007.04.005
New York, NY: John Wiley & Sons, Inc. Struijs, S. Y., Lamers, F., Rinck, M., Roelofs, K., Spinhoven, P., & Penninx,
Ricarte, J. J., Aizpurúa, E., Ros, L., Latorre, J. M., & Raes, F. (2018). Psy- B.W. J. (2018). The predictive value of approach and avoidance
chometric properties of the Spanish Short Depressive Rumination tendencies on the onset and course of depression and anxiety disorders.
Scale in a nonclinical sample. The Spanish Journal of Psychology, 21, 1-10. Depression and Anxiety, 35, 551-559. doi: 10.1002/da.22760
doi: 10.1017/sjp.2018.35 Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.).
Robichaud, M., Dugas, M. J., & Conway, M. (2003). Gender differences in Boston, MA: Allyn & Bacon.
worry and associated cognitive-behavioral variables. Journal of Anxiety Watkins, E. D., & Moulds, M. (2009). Thought Control Strategies, Thought
Disorders, 17, 501- 516. doi: 10.1016/S0887-6185(02)00237-2 Suppression, and Rumination in Depression. International Journal of Cog-
Sagui-Henson, S. J. (2017). Cognitive Avoidance. Encyclopedia of Personality and nitive Therapy, 2, 235-251. doi:10.1521/ijct.2009.2.3.235
Individual Differences, 1–3. doi:10.1007/978-3-319-28099-8_964-1 Wegner, D. M., & Zanakos, S. (1994). Chronic thought suppression. Journal
Sandín, B., Chorot, P., Valiente, R. M., & Lostao, L. (2009). Validación es- of Personality, 62, 615–640. doi: 10.1111/j.1467-6494. 1994.tb00311.x
pañola del cuestionario de preocupación PSWQ: estructura factorial y

anales de psicología / annals of psychology, 2020, vol. 36, nº 3 (october)

Copyright of Anales de Psicología is the property of Servicio de Publicaciones de la
Universidad de Murcia and its content may not be copied or emailed to multiple sites or
posted to a listserv without the copyright holder's express written permission. However, users
may print, download, or email articles for individual use.