Department of Psychology.
Psychol Trauma. 2020 Sep;12(6):651-658. doi: 10.1037/tra0000601. Epub 2020 Jun 4.
The current study sought to investigate whether experiential avoidance (EA) mediates the effect of shame on posttraumatic symptoms (PTS) in a population of trauma-exposed individuals. Given demonstrated gender differences in posttraumatic stress disorder (PTSD), the current cross-sectional study also sought to examine whether gender moderates this mediational proposed effect. EA has been shown to mediate shame and depression symptoms, suggesting that the unwillingness to feel and/or the attempt to control shame may be an important factor in later psychopathological symptoms. Furthermore, EA appears to influence PTS over time.
Trauma-exposed undergraduates ( = 326, 68.8% male, = 19.35, = 2.30) at a large Midwestern university completed measures of shame, EA, and PTS.
EA was found to fully mediate the relationship between shame and PTS. The role of gender was mixed as it moderated the relationship between EA and PTS such that the effect of EA is stronger for men than women; however, when analyzed with more robust methods, the effect of gender was no longer significant. A competing, flipped mediational model was run to further assess the direction of hypothesized relationships, but shame was not a significant mediator of EA and PTSD symptoms.
Results provide further evidence for the centrality of EA in maintaining PTS and suggest targeting EA rather than shame in treatment as an avenue for intervention. Future research is needed to investigate gender differences in engagement in EA. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
本研究旨在探讨经历性回避(experiential avoidance,EA)是否在创伤后人群中中介了羞耻感对创伤后症状(posttraumatic symptoms,PTS)的影响。鉴于创伤后应激障碍(posttraumatic stress disorder,PTSD)存在明显的性别差异,本横断面研究还试图检验这种中介效应是否受到性别因素的调节。EA 已被证明中介了羞耻感和抑郁症状,这表明不愿意感受和/或试图控制羞耻感可能是日后发生精神病理学症状的一个重要因素。此外,EA 似乎会随时间影响 PTS。
在一所中西部的大型大学中,对创伤后大学生(n = 326,68.8%为男性,Mage = 19.35,SD = 2.30)进行了羞耻感、经历性回避和 PTS 的测量。
EA 完全中介了羞耻感和 PTS 之间的关系。性别角色的作用是混合的,因为它调节了 EA 和 PTS 之间的关系,使得 EA 对男性的影响大于女性;然而,当使用更稳健的方法进行分析时,性别因素的影响不再显著。进一步使用竞争性的反转中介模型来评估假设关系的方向,但结果显示羞耻感不是 EA 和 PTSD 症状的显著中介。
结果进一步提供了 EA 在维持 PTS 中的核心作用的证据,并表明在治疗中针对 EA 而不是羞耻感作为干预途径可能更有效。未来的研究需要调查 EA 中性别差异的参与情况。