Patel Tapan A, Blakey Shannon M, Halverson Tate F, Mann Adam J D, Calhoun Patrick S, Beckham Jean C, Pugh Mary J, Kimbrel Nathan A
Department of Psychology, Florida State University; Tallahassee, FL.
RTI International; Research Triangle Park, NC.
Int J Cogn Ther. 2023 Apr 14;1. doi: 10.1007/s41811-023-00164-2.
Experiential avoidance (EA) is associated with posttraumatic stress disorder (PTSD) and self-injurious thoughts and behaviors (SITBs) across different populations, and extant literature has demonstrated a strong relationship between PTSD and SITBs. However, no study has explored the potential moderating role EA plays in the association of PTSD with nonsuicidal self-injury (NSSI), suicidal ideation, and suicide attempts. The objective of the present study was to determine if EA would moderate the association with PTSD and SITBs such that the association between PTSD and individuals SITBs would be stronger among individuals with higher EA. In a large national sample of Gulf War Era veterans ( = 1,138), EA was associated with PTSD, lifetime and past-year NSSI, current suicidal ideation, and lifetime suicide attempts in bivariate analyses. Multivariate analyses detected a significant EA by PTSD interaction on lifetime NSSI ( = 0.96), past-year NSSI ( = 1.03), and suicide attempts ( =1.03). Probing of the interactions revealed that the respective associations between PTSD, lifetime and past-year NSSI, and suicide attempts were stronger at lower levels of EA (i.e., better), counter to our hypotheses. These preliminary findings contextualize the relationship between these variables in a Gulf War veterans sample and signal the need to further investigate these relationships. Further, these findings highlight the need for advancement in assessment and intervention of EA and SITBs.
经验性回避（EA）在不同人群中与创伤后应激障碍（PTSD）以及自我伤害性想法和行为（SITBs）相关，并且现有文献已证明PTSD与SITBs之间存在密切关系。然而，尚无研究探讨EA在PTSD与非自杀性自我伤害（NSSI）、自杀意念及自杀未遂之间的关联中所起的潜在调节作用。本研究的目的是确定EA是否会调节PTSD与SITBs之间的关联，从而使PTSD与个体SITBs之间的关联在EA水平较高的个体中更强。在一个来自海湾战争时期退伍军人的大型全国样本（n = 1138）中，在双变量分析中，EA与PTSD、终生及过去一年的NSSI、当前自杀意念和终生自杀未遂相关。多变量分析检测到EA与PTSD在终生NSSI（β = 0.96）、过去一年NSSI（β = 1.03）和自杀未遂（β = 1.03）上存在显著交互作用。对交互作用的探究表明，PTSD与终生及过去一年NSSI以及自杀未遂之间的各自关联在较低EA水平（即更好）时更强，这与我们的假设相反。这些初步发现将这些变量之间的关系置于海湾战争退伍军人样本的背景中，并表明需要进一步研究这些关系。此外，这些发现凸显了在EA和SITBs的评估与干预方面取得进展的必要性。
