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The Roles of Cognitive Flexibility and Experiential Avoidance in Explaining Psychological Distress in Survivors of Interpersonal Victimization

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Abstract

The long-term negative psychological consequences associated with interpersonal victimization are significant; however a history of interpersonal victimization alone does not necessarily lead to greater long-term psychological distress. The current study examined the relationship between cognitive flexibility, experiential avoidance, and psychological distress among 92 women who reported a history of interpersonal victimization. The findings indicate that both cognitive flexibility and experiential avoidance are significantly related to posttraumatic stress symptomology and depression in this sample. Preliminary evidence is also presented suggesting experiential avoidance maybe a potential mediator between cognitive flexibility and psychological distress in this sample. The current findings suggest that treatments targeting greater emotional acceptance and mindfulness might be useful approaches in working with survivors of interpersonal victimization.

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Notes

  1. Hayes et al. (2006) discuss this as “psychological flexibility.” For the sake of consistency in the current paper, we refer to this concept as “cognitive flexibility.” However, it should be noted that the term “psychological flexibility” has been described more broadly, including cognitive flexibility and behavioral flexibility. The reader is referred to Hayes et al. (2006) for a more detailed description of psychological flexibility.

References

  • Alexander, C. N., Langer, E. J., Newman, R. I., Chandler, H. M., & Davies, J. L. (1989). Transcendental meditation, mindfulness, and longevity: an experimental study with the elderly. Journal of Personality and Social Psychology, 57(6), 950–964.

    Article  PubMed  Google Scholar 

  • American Psychological Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington: American Psychiatric Association.

    Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.

    Article  PubMed  Google Scholar 

  • Batten, S. V., & Hayes, S. C. (2005). Acceptance and Commitment Therapy in the treatment of comorbid substance abuse and post-traumatic stress disorder: a case study. Clinical Case Studies, 4, 246–262.

    Article  Google Scholar 

  • Batten, S. V., Follette, V. M., & Aban, I. B. (2001). Experimental avoidance and high-risk sexual behavior in survivors of child sexual abuse. Journal of Child Sexual Abuse, 10(2), 101–120.

    Article  PubMed  Google Scholar 

  • Baumeister, H., & Harter, M. (2007). Prevalence of mental disorders based on general population surveys. Social Psychiatry and Psychiatric Epidemiology, 42(7), 537–546.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory — II. San Antonio: Psychological Corporation.

    Google Scholar 

  • Becker, C. B., & Zayfert, C. (2001). Integrating DBT-Based techniques and concepts to facilitate exposure treatment of PTSD. Cognitive and Behavioral Practice, 8, 107–122.

    Article  Google Scholar 

  • Benson, B. J., Gohm, C. L., & Gross, A. M. (2007). College women and sexual assault: the role of sex-related alcohol expectancies. Journal of Family Violence, 22, 341–351.

    Article  Google Scholar 

  • Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy, 34(8), 669–673.

    Article  PubMed  Google Scholar 

  • Bond, F. W., & Bunce, D. (2003). The role of acceptance and job control in mental health, job satisfaction, and work performance. The Journal of Applied Psychology, 88(6), 1057–1067.

    Article  PubMed  Google Scholar 

  • Breslau, N. (2009). The epidemiology of trauma, PTSD, and other posttrauma disorders. Trauma, Violence & Abuse, 10(3), 198–210.

    Article  Google Scholar 

  • Breslau, N., Davis, G. C., Andreski, P., & Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48(3), 216–222.

    PubMed  Google Scholar 

  • Breslau, N., Kessler, R. C., Chilcoat, H. D., Schultz, L. R., Davis, G. C., & Andreski, P. (1998). Trauma and posttraumatic stress disorder in the community: the 1996 detroit area survey of trauma. Archives of General Psychiatry, 55(7), 626–632.

    Article  PubMed  Google Scholar 

  • Breslau, N., Davis, G. C., & Schultz, L. R. (2003). Posttraumatic stress disorder and the incidence of nicotine, alcohol, and other drug disorders in persons who have experienced trauma. Archives of General Psychiatry, 60(3), 289–294.

    Article  PubMed  Google Scholar 

  • Briere, J., & Runtz, M. (1993). Child sexual abuse: long-term sequelae and implications for psychological assessment. Journal of Interpersonal Violence, 8, 312–330.

    Article  Google Scholar 

  • Chawla, N., & Ostafin, B. (2007). Experiential avoidance as a functional dimensional approach to psychopathology: an empirical review. Journal of Clinical Psychology, 63(9), 871–890.

    Article  PubMed  Google Scholar 

  • Elliott, D. M., Mok, D. S., & Briere, J. (2004). Adult sexual assault: prevalence, symptomatology, and sex differences in the general population. Journal of Traumatic Stress, 17(3), 203–211.

    Article  PubMed  Google Scholar 

  • Fresco, D. M., Heimberg, R. G., Abramowitz, A., & Bertram, T. L. (2006a). The effect of a negative mood priming challenge on dysfunctional attitudes, explanatory style, and explanatory flexibility. The British Journal of Clinical Psychology, 45(Pt 2), 167–183.

    Article  PubMed  Google Scholar 

  • Fresco, D. M., Williams, N. L., & Nugent, N. R. (2006b). Association of explanatory flexibility and coping flexibility to each other and to depression and anxiety. Cognitive Therapy and Research, 30, 201–210.

    Article  Google Scholar 

  • Gratz, K. L., Bornovalova, M. A., Delany-Brumsey, A., Nick, B., & Lejuez, C. W. (2007). A laboratory-based study of the relationship between childhood abuse and experiential avoidance among inner-city substance users: the role of emotional nonacceptance. Behavior Therapy, 38(3), 256–268.

    Article  PubMed  Google Scholar 

  • Green, B. L., Goodman, L. A., Krupnick, J. L., Corcoran, C. B., Petty, R. M., Stockton, P., et al. (2000). Outcomes of single versus multiple trauma exposure in a screening sample. Journal of Traumatic Stress, 13(2), 271–286.

    Article  PubMed  Google Scholar 

  • Hayes, S.C. (2004). Acceptance and commitment therapy and the new behavior therapies: Mindfulness, acceptance, and relationship. In S.C. Hayes, V.M. Follette, and M.M. Linehan (eds.) (pp.1-29). Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition. New York: Guilford.

  • Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152–1168.

    Article  PubMed  Google Scholar 

  • Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: The Guilford Press.

    Google Scholar 

  • Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, S., et al. (2004). Measuring experiential avoidance: a preliminary test of a working model. Psychological Record, 54(4), 553–578.

    Google Scholar 

  • Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1–25.

    Article  PubMed  Google Scholar 

  • Helzer, J. E., Robins, L. N., & McEvoy, L. (1987). Post-traumatic stress disorder in the general population. Findings of the epidemiologic catchment area survey. New England Journal of Medicine, 317(26), 1630–1634.

    Article  PubMed  Google Scholar 

  • Holmbeck, G. N. (1997). Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: examples from the child-clinical and pediatric psychology literatures. Journal of Consulting and Clinical Psychology, 65(4), 599–610.

    Article  PubMed  Google Scholar 

  • Howard, L. M., Trevillion, K., Khalifeh, H., Woodall, A., Agnew-Davies, R., & Feder, G. (2010). Domestic violence and severe psychiatric disorders: prevalence and interventions. Psychological Medicine, 40(6), 881–893.

    Article  PubMed  Google Scholar 

  • Jaycox, L. H., Ebener, P., Damesek, L., & Becker, K. (2004). Trauma exposure and retention in adolescent substance abuse treatment. Journal of Traumatic Stress, 17(2), 113–121.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048–1060.

    PubMed  Google Scholar 

  • Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National Survey of Adolescents. Journal of Consulting and Clinical Psychology, 71(4), 692–700.

    Article  PubMed  Google Scholar 

  • Kingston, J., Clarke, S., & Remington, B. (2010). Experiential avoidance and problem behavior: a mediational analysis. Behavior Modification, 34(2), 145–163.

    Article  PubMed  Google Scholar 

  • Lang, A. J., Laffaye, C., Satz, L. E., Dresselhaus, T. R., & Stein, M. B. (2003). Sensitivity and specificity of the PTSD checklist in detecting PTSD in female veterans in primary care. Journal of Traumatic Stress, 16(3), 257–264.

    Article  PubMed  Google Scholar 

  • Langer, E. J. (1989). Mindfulness. Reading: Addison Wesley.

    Google Scholar 

  • Linehan, M. M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York: Guilford Press.

    Google Scholar 

  • MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods, 7(1), 83–104.

    Article  PubMed  Google Scholar 

  • Martin, M. M., & Anderson, C. M. (1998). The cognitive flexibility scale: three validty studies. Communication Reports, 11, 1–9.

    Google Scholar 

  • Martin, M. M., & Rubin, R. B. (1995). A new measure of cognitive flexibility. Psychological Reports, 76, 623–626.

    Google Scholar 

  • Marx, B. P., & Sloan, D. M. (2005). Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology. Behaviour Research and Therapy, 43(5), 569–583.

    Article  PubMed  Google Scholar 

  • Merwin, R. W., Rosenthal, M. Z., & Coffey, K. A. (2009). Experiential avoidance mediates the relationship between sexual victimization and psychological symptoms: replicating findings with an ethnically diverse sample. Cognitive Therapy and Research, 33, 537–542.

    Article  Google Scholar 

  • Morina, N. (2007). The role of experiential avoidance in psychological functioning after war-related stress in Kosovar civilians. The Journal of Nervous and Mental Disease, 195(8), 697–700.

    Article  PubMed  Google Scholar 

  • Orcutt, H. K., Pickett, S. M., & Pope, E. B. (2005). Experiential avoidance and forgiveness as mediators in the relation between traumatic interpersonal events and posttraumatic stress disorder symptoms. Journal of Social and Clinical Psychology, 24, 1003–1029.

    Article  Google Scholar 

  • Orsillo, S. M., & Batten, S. V. (2005). Acceptance and commitment therapy in the treatment of posttraumatic stress disorder. Behavior Modification, 29(1), 95–129.

    Article  PubMed  Google Scholar 

  • Palm, K. M., & Follette, V. M. (2008). Sexual victimization and physical health: an examination of explanatory mechanisms. Journal of Child Sexual Abuse, 17(2), 117–132.

    Article  PubMed  Google Scholar 

  • Peterson, C., Bishop, M. P., Fletcher, C. W., Kaplan, M. R., Yesko, E. S., Moon, C. H., et al. (2001). Explanatory style as a risk factor for traumatic mishaps. Cognitive Therapy and Research, 25, 633–649.

    Article  Google Scholar 

  • Plumb, J. C., Orsillo, S. M., & Luterek, J. A. (2004). A preliminary test of the role of experiential avoidance in post-event functioning. Journal of Behavior Therapy and Experimental Psychiatry, 35(3), 245–257.

    Article  PubMed  Google Scholar 

  • Polusny, M. A., & Follette, V. (1995). Long-term correlates of child sexual abuse: theory and review of the empirical literature. Applied and Preventive Psychology, 4, 143–166.

    Article  Google Scholar 

  • Polusny, M. A., Rosenthal, M. Z., Aban, I., & Follette, V. M. (2004). Experimental avoidance as a mediator of the effects of adolescent sexual victimization on negative adult outcomes. Violence and Victims, 19(1), 109–120.

    Article  PubMed  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36(4), 717–731.

    Article  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891.

    Article  PubMed  Google Scholar 

  • Rosenthal, M. Z., Rasmussen Hall, M. L., Palm, K. M., Batten, S. V., & Follette, V. (2005). Chronic avoidance helps explain the relationship between severity of childhood sexual abuse and psychological distress in adulthood. Journal of Child Sexual Abuse, 14(4), 25–41.

    Article  PubMed  Google Scholar 

  • Roy-Byrne, P. P., Russo, J., Michelson, E., Zatzick, D., Pitman, R. K., & Berliner, L. (2004). Risk factors and outcome in ambulatory assault victims presenting to the acute emergency department setting: implications for secondary prevention studies in PTSD. Depression and Anxiety, 19(2), 77–84.

    Article  PubMed  Google Scholar 

  • Ruggiero, K. J., Del Ben, K., Scotti, J. R., & Rabalais, A. E. (2003). Psychometric properties of the PTSD Checklist-Civilian Version. Journal of Traumatic Stress, 16(5), 495–502.

    Article  PubMed  Google Scholar 

  • Silverman, R. J., & Peterson, C. (1993). Explanatory style of schizophrenic and depressed outpatients. Cognitive Therapy and Research, 17, 457–470.

    Article  Google Scholar 

  • Smith, P. H., Thornton, G. E., DeVellis, R., Earp, J. A. L., & Coker, A. L. (2002). A population-based study of the prevalence and distinctiveness of battering, physical assault, and sexual assault in intimate relationships. Violence Against Women, 8, 1208–1232.

    Article  Google Scholar 

  • Sobel, M. E. (1982). Aysymptomatic confidence intervals for indirect effects in structural equation models. In S. Leinhart (Ed.), Sociological Methodology 1982 (pp. 290–312). San Francisco: Jossey-Bass.

    Google Scholar 

  • Sorenson, S. B., Stein, J. A., Siegel, J. M., Golding, J. M., & Burnam, M. A. (1987). The prevalence of adult sexual assault. The Los Angeles epidemiologic catchment area project. American Journal of Epidemiology, 126(6), 1154–1164.

    PubMed  Google Scholar 

  • Tabachnick, B.G., & Fidell, L.S. (2000). Using multivariate statistics (4th ed.). Boston: Allyn & Bacon.

  • Thompson, B. L., & Waltz, J. (2010). Mindfulness and experiential avoidance as predictors of posttraumatic stress disorder avoidance symptom severity. Journal of Anxiety Disorders, 24(4), 409–415.

    Article  PubMed  Google Scholar 

  • Ullman, S. E., & Siegel, J. M. (1994). Predictors of exposure to traumatic events and posttraumatic stress sequelae. Journal of Community Psychology, 22, 328–338.

    Article  Google Scholar 

  • Ullman, S. E., Karabatsos, G., & Koss, M. P. (1999). Alcohol and sexual assault in a national sample of college women. Journal of Interpersonal Violence, 14, 603–625.

    Article  Google Scholar 

  • Walser, R. D., & Westrup, D. (2007). Acceptance & commitment therapy for the treatment of post-traumatic stress disorder: A practitioner’s guide to using mindfulness & acceptance strategies. Oakland: New Harbinger Publications, Inc.

    Google Scholar 

  • Weathers, F. W., Litz, B., Huska, J., & Keane, T. M. (1994). PTSD Checklist (PCL). Boston: National Center for PTSD — Behavioral Science Division.

    Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, Clark University, 950 Main Street, Worcester, MA, 01610, USA

    Kathleen M. Palm

  2. Department of Psychology, University of Nevada, Reno, NV, USA

    Victoria M. Follette

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  1. Kathleen M. Palm
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  2. Victoria M. Follette
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Correspondence to Kathleen M. Palm.

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Palm, K.M., Follette, V.M. The Roles of Cognitive Flexibility and Experiential Avoidance in Explaining Psychological Distress in Survivors of Interpersonal Victimization. J Psychopathol Behav Assess 33, 79–86 (2011). https://doi.org/10.1007/s10862-010-9201-x

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