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Experiential Avoidance and Psychoactive Substance Use: Systematic Review.

Gabriela Sequeda1, Sandra Durán-Rondón1, Johan E Acosta-López2

  • 1Universidad Simón Bolívar, Facultad de Ciencias Jurídicas y Sociales, Grupo de Investigación en Modelamiento Científico e Innovación Empresarial, Cúcuta 540001, Colombia.

European Journal of Investigation in Health, Psychology and Education
|February 26, 2026
PubMed
Summary
This summary is machine-generated.

Experiential avoidance (EA), the tendency to evade unpleasant experiences, is strongly linked to substance use disorders. Interventions promoting psychological flexibility show promise in reducing addiction severity and improving treatment outcomes.

Keywords:
Acceptance and Commitment Therapy (ACT)addictionemotion regulationexperiential avoidancesubstance use

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Area of Science:

  • Psychology
  • Psychiatry
  • Behavioral Science

Background:

  • Experiential avoidance (EA) involves evading distressing internal experiences.
  • EA is increasingly recognized as a key factor in the development and persistence of addictive behaviors.

Purpose of the Study:

  • To systematically review quantitative evidence on the link between EA (as psychological inflexibility) and psychoactive substance use (PSU) outcomes.
  • To explore EA's role as a predictor or mediator in substance use and its correlates, such as affect regulation and trauma.

Main Methods:

  • Systematic literature search across major databases (SCOPUS, Web of Science, PubMed, APA PsycNet) following PRISMA 2020 guidelines.
  • Included experimental and observational studies from 2000-2026, focusing on PSU behavior, severity, treatment response, and related correlates.

Main Results:

  • Higher EA consistently correlated with increased substance use (alcohol, tobacco, cannabis, illicit drugs).
  • EA frequently mediated the link between emotional dysregulation, trauma, and addictive behaviors.
  • Elevated EA was associated with impulsivity, comorbidity, and poorer treatment outcomes; Acceptance and Commitment Therapy (ACT) showed positive effects.

Conclusions:

  • Experiential avoidance is a transdiagnostic factor in vulnerability and persistence of substance use disorders.
  • Integrating interventions that enhance psychological flexibility may improve addiction treatment efficacy.
  • Further research is needed in diverse cultural contexts.