A Meta-Analysis of the Role of Defeat and Entrapment in Depression, Anxiety Problems, Post-Traumatic Stress Disorder and Suicidality

Abstract

Research investigating the role of two evolutionary constructs – perceptions of defeat and entrapment – in various psychological problems and processes has burgeoned over recent years. This meta-analysis quantitatively summarised the findings from 38 studies (11,343 participants) which examined relationships between perceptions of defeat and entrapment and four psychological problems commonly encountered in NHS clinical services: depression, suicidality, anxiety problems and Post-Traumatic Stress Disorder (PTSD). All correlations between defeat and entrapment and the four psychological problems were large by Cohen’s (1988) criterion. Correlations between defeat and entrapment and depression were larger than those for the other psychological problem groups, and significantly larger than those for anxiety problems and PTSD. The magnitude of the observed correlations introduces the possibility that defeat and entrapment, and perhaps other evolutionary constructs, may be integral components or driving forces behind all psychological problems. A robust approach to sensitivity analysis provided confidence that the population effect size estimates are robust and were not severely inflated by unpublished studies not included in the meta-analysis. As there was no significant between-study heterogeneity, moderator analyses were undertaken on an exploratory basis. Findings are generally consistent with theoretical predictions from the Involuntary Defeat Strategy, the theoretical model underpinning the literature. Overall, perceptions of defeat and entrapment appear to be strong risk factors for the four psychological problems examined, perhaps representing transdiagnostic processes that are common across various psychological problems. The potential role of defeat and entrapment in mental health assessment, formulation, intervention and evaluation, is considered in detail and limitations of this meta-analysis and of the literature on which it is based are discussed, highlighting areas of research where future work is needed.