Psychology Ph.D. Dissertations

The Relationships between Acceptance, Avoidance, and Immunity in Medical Rehabilitation

Date of Award


Document Type


Degree Name

Doctor of Philosophy (Ph.D.)



First Advisor

William O'Brien (Advisor)

Second Advisor

Howard Cromwell (Committee Member)

Third Advisor

Kenneth Pargament (Committee Member)

Fourth Advisor

L. Fleming Fallon (Committee Member)


Research indicates that acceptance and avoidance play a role in medical rehabilitation recovery. Acceptance, defined as nonjudgmentally experiencing emotions, thoughts, and physiological sensations without attempting to avoid or alter these experiences or letting them control one's actions, has generally been related to better psychosocial outcomes while avoidance, defined as the conscious effort to avoid distressing emotions, thoughts, and physiological sensations, has generally shown to be related to poorer psychosocial outcomes. When considering their impact on immunological functioning, a review of the existing literature reveals that acceptance appears to be associated with better immunological functioning while avoidance has generally been related to poorer immunological functioning. The number of studies on these relationships is limited, though, particularly within a medical rehabilitation population. A psychoneuroimmunological framework is used to identify and describe the mechanisms likely underlying the relationships between acceptance/avoidance and immune functioning, and highlights their potential role as mediators in stress-immunity pathways. The present study examined the interrelationships between acceptance, avoidance, and immunity within a medical rehabilitation population and examined the potential mediating role of acceptance and avoidance in the stress-immunity relationships. Results provided preliminary support for relationships between acceptance/avoidance and immunity, as well as for the theoretical validity of the acceptance, avoidance, and stress constructs measured in this study. Limitations of the present study are explored and subsequent indications for future research directions are discussed.