Experiential avoidance, self-efficacy, rejection sensitivity, and psychological symptoms in individuals with and without chronic illness

The comorbidities of chronic physical illnesses and mental disorders are quite common, and the interaction of mental health issues with other health conditions indicates the need to examine psychological factors for effective intervention methods. This study aims to investigate the differences between individuals with and without chronic illness in terms of experiential avoidance, self-efficacy, rejection sensitivity, and psychological symptoms (anxiety and depression), as well as to test the mediating role of experiential avoidance in the relationship between self-efficacy, rejection sensitivity, and psychological symptoms among individuals with chronic illness. The sample comprised 221 volunteer participants (109 with chronic illness, 112 without chronic illness). Individuals with chronic illness exhibited higher levels of experiential avoidance, rejection sensitivity, anxiety, and depression, as well as lower self-efficacy, compared to those without chronic illness. The effect sizes of the differences between the groups ranged from medium to large. In the chronic illness group, self-efficacy and rejection sensitivity predicted psychological symptoms through the full mediation of experiential avoidance. The model explained 31.2% of experiential avoidance and 34.4% of the psychological symptoms. Additionally, causal mediation analyses and sensitivity analyses affirmed the robustness of these mediation effects. Implications for clinical practice were discussed, suggesting the importance of a holistic perspective and psychological interventions for individuals with chronic illness, as well as the potential functionality of interventions that address experiential avoidance in the relationship between self-efficacy, rejection sensitivity, and psychological health among these individuals.