The Relationship Between Experiential Avoidance and Posttraumatic Stress Symptoms: A Moderated Mediation Model Involving Dissociation, Guilt, and Gender

Serrano‐Ibáñez, Elena R.; Ruíz-Párraga, Gema T.; Gómez-Pérez, Lidia; Ramírez‐Maestre, Carmen; Esteve, Rosa; López‐Martínez, Alicia E.

doi:10.1080/15299732.2020.1869647

Cited by 11 publications

(8 citation statements)

References 55 publications

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“…For our purpose, psychological inflexibility has been theorized to play a role in the cause and maintenance of substance use disorders ( Levin et al, 2012 , 2014 ). In the present study, women reported significantly higher levels of psychological inflexibility than men students did, being such results consistent with precedent research ( Levin et al, 2012 ; Mendoza et al, 2016 ; Serrano-Ibáñez et al, 2021 ). This could be explained due to the differences between men and women regarding their emotional processing ( Whittle et al, 2011 ), as women tend to experience more negative affect than men and report more frequent and intense negative emotions ( Brebner, 2003 ), which can lead them to avoid these emotions.…”

Section: Discussionsupporting

confidence: 92%

Gender Differences in Transdiagnostic Predictors of Problematic Alcohol Consumption in a Large Sample of College Students in Ecuador

et al. 2022

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BackgroundAlcohol use is one of the main risk factors that leads to detrimental health effects and support for a transdiagnostic approach to alcohol use disorders is growing. However, the role of transdiagnostic predictors of problematic alcohol consumption in Ecuador are understudied.ObjectiveThe aim of this study was to examine gender differences in psychological stress and inflexibility as transdiagnostic predictors of problematic alcohol consumption in a large sample of college students in Ecuador.MethodsA total of 7,905 college students (21.49 years, SD = 3.68; 53.75% females) were surveyed using the following standardized scales: Alcohol Use Disorders Identification Test, Perceived Stress Scale-14, and Acceptance and Action Questionnaire (AAQ-7). Macro Process for SPSS (models 4 and 7) was used to analyze mediation and moderation effects.ResultsReported alcohol consumption was significantly higher in men than women students. On the other hand, women reported significantly higher levels of perceived stress and psychological inflexibility than men students. Gender, age, psychological stress, and inflexibility were significant predictors of alcohol consumption. Moreover, psychological inflexibility mediated the impact of stress on alcohol consumption, particularly in women (for men b = 0.065, 95% CI [0.048 to 0.083], for women b = 0.070, 95% CI [0.051 to 0.089]).DiscussionResults of this study support psychological stress and psychological inflexibility as critical transdiagnostic variables related to increased rates of alcohol consumption among Ecuadorian college students. These conclusions contribute to the development of transdiagnostic comprehensive programs, which encompasses promotive, preventive, and treatment services that allow to alleviate the burden of alcohol, as well as to enrich the growing research on alcohol consumption in this population from a gender perspective.

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Section: Discussionsupporting

confidence: 92%

Gender Differences in Transdiagnostic Predictors of Problematic Alcohol Consumption in a Large Sample of College Students in Ecuador

et al. 2022

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“…Furthermore, given that experiential avoidance is an important predictor of psychiatric disorders, including depression, anxiety, prolonged grief, and PTSD (Marx & Sloan, 2005b;Serrano-Ibanez et al, 2021;Spinhoven et al, 2016;Spinhoven et al, 2017;Williams et al, 2019), reducing such avoidance may have longer-term psychological benefits.…”

Section: Discussionmentioning

confidence: 99%

“…The focus on providing individually tailored tools for higher-risk individuals distinguishes EMPOWER from interventions like critical incident stress debriefing (Mitchell and Everly, 1995; Gartlehner et al, 2013). Ultimately, EMPOWER aims to help surrogates make difficult decisions by building tolerance for painful feelings and negative intrusive thoughts, and by minimizing future chronic avoidance (e.g., of emotional triggers), so that normative acute stress and grief responses do not escalate into pathological reactions like PTSD and PGD (Marx and Sloan, 2005; Bishop et al, 2018; Williams et al, 2019; Serrano-Ibanez et al, 2021). The intervention manual also notes adaptations for various cultural and ethnic populations and the importance of cultural competence in delivering EMPOWER to diverse surrogate groups.…”

Section: Methodsmentioning

confidence: 99%

“…The focus on providing individually-tailored tools for higher-risk individuals distinguishes EMPOWER from interventions like critical incident stress debriefing (Gartlehner et al, 2013;Mitchell & Everly, 1995). Ultimately, EMPOWER aims to help surrogates make difficult decisions by building tolerance for painful feelings and negative intrusive thoughts, and EMPOWER FOR SURROGATES OF CRITICALLY ILL PATIENTS by minimizing future chronic avoidance (e.g., of emotional triggers), so that normative acute stress and grief responses do not escalate into pathological reactions like PTSD and PGD (Bishop et al, 2018;Marx & Sloan, 2005a;Serrano-Ibanez et al, 2021;Williams et al, 2019).…”

Section: Intervention and Conceptual Model Descriptionmentioning

confidence: 99%

“…Our conceptual model posits that symptoms of grief, anxiety, traumatic stress, and related maladaptive coping reactions such as dissociation and avoidance, interfere with engaging in value-concordant and empowered end-of-life decision-making (Glick et al, 2018). We highlight the role in coping of experiential avoidance, which is the natural tendency to avoid unpleasant feelings and consideration of negative outcomes (Gamez et al, 2014;Gamez et al, 2011;Plumb et al, 2004) and which has been associated with PTSD and PGD (Bishop et al, 2018;Marx & Sloan, 2005a;Serrano-Ibanez et al, 2021;Williams et al, 2019). There are many subtle ways avoidance may manifest for surrogates.…”

Section: Introductionmentioning

confidence: 99%

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Development and preliminary evaluation of EMPOWER for surrogate decision-makers of critically ill patients

et al. 2021

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Objective The objectives of this study were to develop and refine EMPOWER (Enhancing and Mobilizing the POtential for Wellness and Resilience), a brief manualized cognitive-behavioral, acceptance-based intervention for surrogate decision-makers of critically ill patients and to evaluate its preliminary feasibility, acceptability, and promise in improving surrogates’ mental health and patient outcomes. Method Part 1 involved obtaining qualitative stakeholder feedback from 5 bereaved surrogates and 10 critical care and mental health clinicians. Stakeholders were provided with the manual and prompted for feedback on its content, format, and language. Feedback was organized and incorporated into the manual, which was then re-circulated until consensus. In Part 2, surrogates of critically ill patients admitted to an intensive care unit (ICU) reporting moderate anxiety or close attachment were enrolled in an open trial of EMPOWER. Surrogates completed six, 15–20 min modules, totaling 1.5–2 h. Surrogates were administered measures of peritraumatic distress, experiential avoidance, prolonged grief, distress tolerance, anxiety, and depression at pre-intervention, post-intervention, and at 1-month and 3-month follow-up assessments. Results Part 1 resulted in changes to the EMPOWER manual, including reducing jargon, improving navigability, making EMPOWER applicable for a range of illness scenarios, rearranging the modules, and adding further instructions and psychoeducation. Part 2 findings suggested that EMPOWER is feasible, with 100% of participants completing all modules. The acceptability of EMPOWER appeared strong, with high ratings of effectiveness and helpfulness (M = 8/10). Results showed immediate post-intervention improvements in anxiety (d = −0.41), peritraumatic distress (d = −0.24), and experiential avoidance (d = −0.23). At the 3-month follow-up assessments, surrogates exhibited improvements in prolonged grief symptoms (d = −0.94), depression (d = −0.23), anxiety (d = −0.29), and experiential avoidance (d = −0.30). Significance of results Preliminary data suggest that EMPOWER is feasible, acceptable, and associated with notable improvements in psychological symptoms among surrogates. Future research should examine EMPOWER with a larger sample in a randomized controlled trial.

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Mindfulness in Survivors of Cumulative Childhood Interpersonal Trauma: a Buddhist Conceptualization of Suffering and Healing

et al. 2022

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The Relationship Between Experiential Avoidance and Posttraumatic Stress Symptoms: A Moderated Mediation Model Involving Dissociation, Guilt, and Gender

Cited by 11 publications

References 55 publications

Gender Differences in Transdiagnostic Predictors of Problematic Alcohol Consumption in a Large Sample of College Students in Ecuador

Gender Differences in Transdiagnostic Predictors of Problematic Alcohol Consumption in a Large Sample of College Students in Ecuador

Development and preliminary evaluation of EMPOWER for surrogate decision-makers of critically ill patients

Mindfulness in Survivors of Cumulative Childhood Interpersonal Trauma: a Buddhist Conceptualization of Suffering and Healing

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