The Paradox of Acceptance: A Longitudinal Study on Acceptance, Depression, and the Moderating Role of Anger...

This longitudinal study examined the associations between acceptance of reality and depressive symptoms, in light of inconsistent findings in prior research. Existing studies-mostly cross-sectional-have reported negative, positive, or nonsignificant correlations, leaving the role of acceptance in depression unclear. Despite its prominence in third-wave cognitive-behavioral therapies (Hofmann and Asmundson 2008) such as Acceptance and Commitment Therapy (ACT; Hayes et al. 1999), the nature of this association remains debated. To address these gaps, we explored whether levels of acceptance were related to depressive symptoms over time, and whether anger suppression moderated this relationship.

Self-report data from N = 344 participants who completed the online survey three times, with 2-month intervals between assessments.

Higher individual tendency to accept reality was associated with lower depression symptoms. However, elevating acceptance beyond typical thresholds resulted in higher levels of depressive symptoms at subsequent time points, and no relationship between these variables was identified within measurements. Additionally, anger suppression emerged as a moderator of the negative relationship between an individual's tendency to accept reality and depressive symptoms.

These findings help clarify prior inconsistencies by showing that the acceptance-depression link varies with the level of acceptance, temporal perspective, and anger regulation strategies. Interpreted within the ACT framework, the results highlight that elevated acceptance does not always reflect psychological flexibility, and can co-occur with increased depressive symptoms. We highlight the need for further research to explore the mechanisms behind these patterns and examine whether supportive interventions may assist individuals during such phases.