Experiential avoidance as a moderator of the relationship between behavioral inhibition system sensitivity and posttraumatic stress symptoms

Pickett, Scott M.; Bardeen, Joseph R.; Orcutt, Holly K.

doi:10.1016/j.janxdis.2011.06.013

Cited by 61 publications

(53 citation statements)

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“…Experiential avoidance (EA), defined as an unwillingness to stay in contact with unwanted inner experiences (e.g., thoughts, emotions, physical sensations), as well as steps taken to alter the frequency or form of unwanted inner experiences (Hayes et al 1996), is another individual difference factor that is associated with a wide array of maladaptive outcomes (Chawla and Ostafin 2007), and PTS more specifically (e.g., Pickett et al 2011;Marx and Sloan 2005;Plumb et al 2004). In fact, high levels of EA measured prior to a traumatic event predict increased PTS symptoms in the acute aftermath of the event and 8 months later (Kumpula et al 2011), thus providing temporal evidence of EA as a risk factor for the development of PTS.…”

Section: Pts-related Individual Difference Factorsmentioning

confidence: 99%

Emotional Distress Intolerance, Experiential Avoidance, and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms

Bardeen

Fergus

2015

J Psychopathol Behav Assess

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A number of individual difference factors, including emotional distress intolerance (EDI), experiential avoidance (EA), and anxiety sensitivity (ASI), have been implicated in the development and maintenance of posttraumatic stress (PTS) symptomatology. Attentional control (AC) has been shown to serve as a protective factor against the development of maladaptive psychological outcomes across a number of studies, even among those with outcome-specific vulnerabilities. The purpose of the present study was to examine AC as a moderator of the relations between three constructs pertaining to the way that people relate to their internal experiences (i.e., EDI, EA, AS) and PTS symptoms among a trauma exposed community sample (N=903). As predicted, AC moderated the relations between each individual difference factor and PTS symptoms, such that as attentional control decreased, the strength of the association between each individual difference factor and PTS symptoms increased. Study results suggest that AC abilities may be one factor that differentiates those who recover from trauma from those who do not, even among those who may be vulnerable for developing PTS symptomatology. Clinical implications and results of a PTS cluster level analysis will be discussed.Although it is more common than not to experience trauma in one's lifetime, only a small fraction of trauma-exposed individuals go on to develop posttraumatic stress disorder (PTSD; Breslau 2009). However, because PTSD is associated with severe psychological distress, as well as severe impairment in social, occupational, and family functioning (Brady et al. 2000), substantial effort has been put into identifying risk and resiliency factors that contribute to the pathogenesis of posttraumatic stress (PTS) symptomatology. A number of factors, especially those regarding how people relate to aversive internal experiences (e.g., emotional distress intolerance, experiential avoidance, anxiety sensitivity), have been identified as individual difference factors that contribute to the development and maintenance of PTS. Unfortunately, these factors are often studied in isolation rather than concurrently exploring the conditions under which these factors are more or less likely to relate to PTS. For example, it has been suggested that attentional control (AC; i.e., the strategic control of higherorder executive attention in regulating bottom-up, stimulus driven, emotional responses) may be a transdiagnostic protective factor against the development of maladaptive outcomes, even among those with outcome-specific vulnerabilities (Bardeen et al. 2015a). As such, it may be particularly important to examine the role of AC in the relation between the individual difference factors described above and PTS symptoms. PTS-related Individual Difference FactorsAmong a number of PTS-related individual difference factors, constructs pertaining to the way people relate to their internal experiences (e.g., emotional distress intolerance, experiential avoidance, anxiety sensitivity), have rece...

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Section: Pts-related Individual Difference Factorsmentioning

confidence: 99%

Emotional Distress Intolerance, Experiential Avoidance, and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms

Bardeen

Fergus

2015

J Psychopathol Behav Assess

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“…For instance, a reduction in reward responsiveness in the consummatory phase may be accompanied by an increase in reward-anticipating behaviour (Pickett, Bardeen, & Orcutt, 2011). The importance of discriminating between these two stages of reward behaviour and their relation to clinical symptom expressions is highlighted by findings indicating that emotional numbing predicts risk of chronification of PTSD (Malta, Wyka, Giosan, Jayasinghe, & Difede, 2009; Marshall et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Anhedonia and emotional numbing in treatment-seeking veterans: behavioural and electrophysiological responses to reward

Eskelund¹,

Karstoft

Andersen

2018

European Journal of Psychotraumatology

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Background: Anhedonia is a common symptom following exposure to traumatic stress and a feature of the PTSD diagnosis. In depression research, anhedonia has been linked to deficits in reward functioning, reflected in behavioural and neural responses. Such deficits following exposure to trauma, however, are not well understood.Objective: The current study aims to estimate the associations between anhedonia, PTSD symptom-clusters and behavioural and electrophysiological responses to reward.Methods: Participants (N = 61) were recruited among Danish treatment-seeking veterans at the Department of Military Psychology in the Danish Defence. Before entering treatment, participants were screened with symptom measurement instruments and participated in a joint behavioural-electrophysiological experiment. The experimental paradigm consisted of a signal-detection task aimed at assessing reward-driven learning. Simultaneous electrophysiological-recordings were analysed to evaluate neural responses upon receiving reward, as indicated by the Feedback-Related Negativity (FRN) component.Result: Anhedonia as conceptualized in depression correlated with behavioural learning (r = -0.28, p = .032). Neither anhedonia nor behavioural learning correlated with FRN. However, the anhedonia symptom cluster of PTSD did correlate with FRN (r = 0.29, p = .023). Extending upon this in an exploratory analysis, the specific PTSD-symptom emotional numbing was found to correlate moderately with FRN (r = 0.38, p = .003).Conclusion: The present data suggest that anhedonia in trauma-exposed individuals is related to the anticipatory aspect of reward, whereas the neural consummatory reward response seems unlinked. Interestingly, emotional numbing in the same population is related to the consummatory phase of reward, correlating with the FRN response. This suggests that anhedonia and emotional numbing in response to trauma might pertain to different phases of reward processing.

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“…Research has connected emotion dysregulation with both PTSD (Tull et al, 2007) and SUD (Kassel, 2010), such that adult emotion dysregulation is both correlated with PTSD (Ehring & Quack, 2010;Weiss, Tull, Lavender, & Gratz, 2013), and childhood emotion regulation predicts future substance abuse (Moffitt et al, 2011). Furthermore, rRST has demonstrated that PTSD severity directly relates to the behavioural inhibition system (BIS; Casada & Roache, 2005), and behavioural avoidance system (BAS; Pickett, Bardeen, & Orcutt, 2011). High BIS sensitivity indicates a susceptibility to negative emotions, such as frustration and anxiety, when faced with stressful situations.…”

Section: Discussionmentioning

confidence: 99%

“…Pickett, Bardeen, and Orcutt (2011) investigated experiential avoidance, which is a method of emotion regulation, and BIS and BAS sensitivity. Experiential avoidance was positively associated with PTSS, indicating that a proneness to engaging in experiential avoidance increases PTSS.…”

Section: Discussionmentioning

confidence: 99%

“…BIS activation relates closely to the severity of PTSD symptomatology, with higher BIS activation indicating higher PTSD severity. This relationship is mediated by maladaptive emotion regulation strategies, specifically the utilization of avoidance (Pickett, Bardeen, & Orcutt, 2011). The connection between emotion regulation and rRST with both PTSD and SUD make these two factors highly salient.…”

Section: Overview Of This Researchmentioning

confidence: 99%

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Posttraumatic stress disorder in a therapeutic community for substance use disorders: an evaluation of the influence

Perryman¹

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The purpose of this body of research is twofold. First, to investigate posttraumatic stress disorder (PTSD) in a sample of adults undergoing substance use disorder (SUD) treatment in a therapeutic community (TC) and, second, to apply major psychological theories to help understand the nature of this comorbidity in ways that inform treatment. The focal theories of this research are: emotion dysregulation (Gratz & Roemer, 2004), and revised Reinforcement Sensitivity Theory (rRST; Corr, 2008;Gray & McNaughton, 2000). Rash Impulsiveness will be included as an important dimension of rRST that has been consistently linked to substance misuse. Chapter 1 presents an overview of research related to the thesis as a whole. In Chapter .72, p < .00). Furthermore, the correlations between PTSS and two of the facets of rRST, BAS and fight-flight-freeze sensitivity (FFFS), were significantly correlated (r = -.23 and .49, p < .01, respectively). BAS sensitivity was shown to negatively correlate with PTSS, indicating that lower BAS sensitivity related to higher PTS severity. No relationship was found between the Behavioural Inhibition System (BIS) and PTSS. Finally, Rash Impulsivity significantly correlated with PTSS at intake, r = .50, p < .00. Contrary to hypotheses, and previous research, Rash Impulsivity did not significantly correlate with retention. Theoretical mechanisms linking PTSS and substance misuse were investigated further, with tests of theoretical models in which individual difference factors (facets of the rRST) were related to retention and outcomes from treatment, and facets of emotional dysregulation were tested as mediators of this relationship. Upon investigation through linear regression, no suitable variable was found the mediate the relationship between PTSS and retention.iii The final moderated mediated model, therefore, was not suitable for this population. Limited moderation, though, occurred between the two facets of rRST and retention. Specifically, investigation of the simple slopes showed that FFFS and Rash Impulsivity both moderate the relationship between PTSD and retention at high (+1 SD) and mean scores. These findings indicate that high levels of both facets do interact with PTSD to negatively influence treatment retention.The null findings for both mediation and the moderated mediation model contradict previous research, and may be due to homogeneity in scores across the population. Overall, some implications for treatment can be extrapolated. First, PTSD is highly prevalent in the TC population, and should be assessed using psychometrically valid measures, such as the PCL-C, and addressed in treatment. Second, treatment for SUD does not exacerbate PTSD; on the contrary, PTSS significantly decreased during TC treatment. Finally, as there is solid theoretical support to suggest an influence of emotion dysregulation and Rash Impulsiveness on retention and outcomes, more research needs to be conducted on the role of these two constructs with the intent of creating a better suited rehabi...

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Experiential avoidance as a moderator of the relationship between behavioral inhibition system sensitivity and posttraumatic stress symptoms

Cited by 61 publications

References 45 publications

Emotional Distress Intolerance, Experiential Avoidance, and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms

Emotional Distress Intolerance, Experiential Avoidance, and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms

Anhedonia and emotional numbing in treatment-seeking veterans: behavioural and electrophysiological responses to reward

Posttraumatic stress disorder in a therapeutic community for substance use disorders: an evaluation of the influence

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