Examining the Role of Emotional Avoidance in the Relationship Between Posttraumatic Stress Disorder Symptom Severity and Worry

References

• American Psychiatric Association . 2000 . Diagnostic and statistical manual of mental disorders , 4th ed., text rev. , Washington, DC : American Psychiatric Press .
   Google Scholar
• Baron , R. M. and 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 : 1173 – 1182 .
   PubMed Web of Science ®Google Scholar
• Behar , E. , Alcaine , O. , Zuellig , A. R. and Borkovec , T. D. 2003 . Screening for generalized anxiety disorder using the Penn State Worry Questionnaire: A receiver operating characteristic analysis . Journal of Behavior Therapy and Experimental Psychiatry , 34 : 25 – 43 .
   PubMed Web of Science ®Google Scholar
• Blake , D. D. , Weathers , F. W. , Nagy , L. , Kaloupek , D. G. , Klauminzer , G. , Charney , D. S.. and Keane , T. 1990 . The Clinician Administered PTSD Scale , Boston : National Center for PTSD, Behavioral Science Division .
   Google Scholar
• Blanchard , E. B. , Jones-Alexander , J. , Buckley , T. C. and Forneris , C. A. 1996 . Psychometric properties of the PTSD Checklist (PCL) . Behaviour Research and Therapy , 34 : 669 – 673 .
   PubMed Web of Science ®Google Scholar
• Borkovec , T. D. 1994 . “ The nature, functions and origins of worry ” . In Worrying: Perspectives on theory, assessment, and treatment , Edited by: Davey , G. C. L. and Tallis , F. New York : Wiley . (pp. 5–34)
   Google Scholar
• Borkovec , T. D. , Alcaine , O. M. and Behar , E. 2004 . “ Avoidance theory of worry and generalized anxiety disorder ” . In Generalized anxiety disorders: Advances in research and practice , Edited by: Heimberg , R. G. , Turk , C. L. and Mennin , D. S. New York : Guilford Press . (pp. 77–108)
   Google Scholar
• Borkovec , T. D. and Hu , S. 1990 . The effect of worry on cardiovascular response to phobic imagery . Behaviour Research and Therapy , 28 : 69 – 73 .
   PubMed Web of Science ®Google Scholar
• Borkovec , T. D. and Inz , J. 1990 . The nature of worry in generalized anxiety disorder: A predominance of thought activity . Behaviour Research and Therapy , 28 : 153 – 158 .
   PubMed Web of Science ®Google Scholar
• Borkovec , T. D. and Roemer , L. 1995 . Perceived functions of worry among generalized anxiety disorder subjects: Distraction from more emotionally distressing topics? . Journal of Behavior Therapy and Experimental Psychiatry , 26 : 25 – 30 .
   PubMed Web of Science ®Google Scholar
• Brady , K. T. , Back , S. E. and Coffey , S. F. 2004 . Substance abuse and posttraumatic stress disorder . Current Directions in Psychological Science , 13 : 206 – 209 .
   Web of Science ®Google Scholar
• Breslau , N. , Davis , G. C. , Andreski , P. and Peterson , E. 1991 . Traumatic events and posttraumatic stress disorder in an urban population of young adults . Archives of General Psychiatry , 48 : 216 – 222 .
   PubMed Web of Science ®Google Scholar
• Brewerton , T. D. 2007 . Eating disorders, trauma, and comorbidity: Focus on PTSD . Eating Disorders: The Journal of Treatment and Prevention , 15 : 285 – 304 .
   PubMed Web of Science ®Google Scholar
• Broman-Fulks , J. J. , Ruggiero , K. J. , Green , B. A. , Kilpatrick , D. G. , Danielson , C. K. , Resnick , H. S. and Saunders , B. E. 2006 . Taxometric investigation of PTSD: Data from two nationally representative samples . Behavior Therapy , 37 : 364 – 280 .
   PubMed Web of Science ®Google Scholar
• Brown , T. A. , Antony , M. M. and Barlow , D. H. 1992 . Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample . Behaviour Research and Therapy , 30 : 33 – 38 .
   PubMed Web of Science ®Google Scholar
• Cloitre , M. , Koenen , K. C. , Cohen , L. R. and Han , H. 2002 . Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse . Journal of Consulting and Clinical Psychology , 70 : 1067 – 1074 .
   PubMed Web of Science ®Google Scholar
• Foa , E. B. and Kozak , M. J. 1986 . Emotional processing of fear: Exposure to corrective information . Psychological Bulletin , 99 : 20 – 35 .
   PubMed Web of Science ®Google Scholar
• Gray , M. J. , Litz , B. T. , Hsu , J. L. and Lombardo , T. W. 2004 . Psychometric properties of the Life Events Checklist . Assessment , 11 : 330 – 341 .
   PubMed Web of Science ®Google Scholar
• Grubaugh , A. L. , Elhai , J. D. , Cusack , K. J. , Wells , C. and Frueh , B. C. 2007 . Screening for PTSD in public-sector mental health settings: The diagnostic utility of the PTSD Checklist . Depression and Anxiety , 24 : 124 – 129 .
   PubMed Web of Science ®Google Scholar
• Hayes , S. C. , Strosahl , K. D. and Wilson , K. G. 1999 . Acceptance and commitment therapy: An experiential approach to behavior change , New York : Guilford Press .
   Google Scholar
• Hayes , S. C. , Strosahl , K. D. , Wilson , K. G. , Bissett , R. T. , Pistorello , J. , Toarmino , D. and Polusny , M. A. 2004 . … McCurry. S.M . Measuring experiential avoidance: A preliminary test of a working model. Psychological Record , 54 : 553 – 578 .
   Google Scholar
• Kenny , D. A. , Kashy , D. A. and Bolger , N. 1998 . “ Data analysis in social psychology ” . In The handbook of social psychology , 4th ed. , Edited by: Gilbert , D. , Fiske , S. and Lindzey , G. Vol. 1 , 233 – 265 . Boston : McGraw-Hill .
   Google Scholar
• Kessler , R. C. and Frank , R. G. 1997 . The impact of psychiatric disorders on work loss days . Psychological Medicine , 27 : 861 – 873 .
   PubMed Web of Science ®Google Scholar
• Kessler , R. C. , Hwang , I. , LaBrie , R. , Petukhova , M. , Sampson , N. A. , Winters , K. C. and Shaffer , H. J. 2008 . DSM-IV pathological gambling in the National Comorbidity Survey replication . Psychological Medicine , 38 : 1351 – 1360 .
   PubMed Web of Science ®Google Scholar
• Kessler , R. C. , Sonnega , A. , Bromet , E. , Hughes , M. and Nelson , C. B. 1995 . Posttraumatic stress disorder in the National Comorbidity Survey . Archives of General Psychiatry , 52 : 1048 – 1060 .
   PubMed Web of Science ®Google Scholar
• Kessler , R. C. , Walters , E. E. and Forthofer , M. S. 1998 . The social consequences of psychiatric disorders: III . Probability of marital stability. American Journal of Psychiatry , 155 : 1092 – 1096 .
   PubMed Web of Science ®Google Scholar
• Lovibond , S. H. and Lovibond , P. F. 1995 . Manual for the Depression Anxiety Stress Scales , 2nd ed. , New South Wales, Australia : Psychology Foundation of Australia .
   Google Scholar
• Marshall , R. D. , Olfson , M. , Hellman , F. , Blanco , C. , Guardino , M. and Streuning , E. L. 2001 . Comorbidity, impairment, and suicidality in subthreshold PTSD . American Journal of Psychiatry , 158 : 1467 – 1473 .
   PubMed Web of Science ®Google Scholar
• Marx , B. P. and Sloan , D. M. 2002 . The role of emotion in the psychological functioning of adult survivors of childhood sexual abuse . Behavior Therapy , 33 : 563 – 577 .
   Web of Science ®Google Scholar
• Mennin , D. S. , Heimberg , R. G. , Turk , C. L. and Fresco , D. M. 2005 . Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder . Behaviour Research and Therapy , 43 : 1281 – 1310 .
   PubMed Web of Science ®Google Scholar
• Meyer , T. J. , Miller , M. L. , Metzger , R. L. and Borkovec , T. D. 1990 . Development and validation of the Penn State Worry Questionnaire . Behaviour Research and Therapy , 28 : 487 – 495 .
   PubMed Web of Science ®Google Scholar
• Michael , T. , Halligan , S. L. , Clark , D. M. and Ehlers , A. 2007 . Rumination in posttraumatic stress disorder . Depression and Anxiety , 24 : 307 – 317 .
   PubMed Web of Science ®Google Scholar
• Molina , S. and Borkovec , T. D. 1994 . “ The Penn State Worry Questionnaire: Psychometric properties and associated characteristics ” . In Worrying: Perspectives on theory, assessment, and treatment , Edited by: Davey , G. C. L. and Tallis , F. 265 – 283 . New York : Wiley .
   Google Scholar
• Molina , S. , Borkovec , T. D. , Peasley , C. and Person , D. 1998 . Content analysis of worrisome streams of consciousness in anxious and dysphoric participants . Cognitive Therapy and Research , 22 : 109 – 123 .
   Web of Science ®Google Scholar
• Naifeh, J. A., Tull, M. T., & Gratz, K. L. (in press). Anxiety sensitivity, emotional avoidance, and PTSD symptom severity among crack/cocaine dependent patients in residential treatment. Cognitive Therapy and Research
   Google Scholar
• Orr , S. P. , Metzger , L. J. , Miller , M. W. and Kaloupek , D. G. 2004 . “ Psychophysiological assessment of PTSD ” . In Assessing psychological trauma and PTSD , Edited by: Wilson , J. P. and Keane , T. M. New York : Guilford Press . (2nd ed., pp. 289–343)
   Google Scholar
• Orsillo , S. M. and Batten , S. V. 2005 . Acceptance and commitment therapy in the treatment of posttraumatic stress disorder . Behavior Modification , 29 : 95 – 129 .
   PubMed Web of Science ®Google Scholar
• Resnick , H. S. , Kilpatrick , D. G. , Dansky , B. S. , Saunders , B. E. and Best , C. L. 1993 . Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women . Journal of Consulting and Clinical Psychology , 61 : 984 – 991 .
   PubMed Web of Science ®Google Scholar
• Roemer , L. 2001 . “ Measures for anxiety and related constructs ” . In Practitioner's guide to empirically-based measures of anxiety , Edited by: Antony , M. M. , Orsillo , S. M. and Roemer , L. 49 – 86 . New York : Kluwer Academic/Plenum .
   Google Scholar
• Roemer , L. , Lee , J. K. , Salters-Pedneault , K. , Erisman , S. M. , Orsillo , S. M. and Mennin , D. S. 2009 . Mindfulness and emotion regulation difficulties in generalized anxiety disorder: Preliminary evidence for independent and overlapping contributions . Behavior Therapy , 40 : 142 – 154 .
   PubMed Web of Science ®Google Scholar
• Roemer , L. , Litz , B. T. , Orsillo , S. M. and Wagner , A. W. 2001 . A preliminary investigation of the role of strategic withholding of emotions in PTSD . Journal of Traumatic Stress , 14 : 149 – 156 .
   Web of Science ®Google Scholar
• Roemer , L. , Molina , S. , Litz , B. T. and Borkovec , T. D. 1996/1997 . Preliminary investigation of the role of previous exposure to potentially traumatizing events in generalized anxiety disorder . Depression and Anxiety , 4 : 134 – 138 .
   PubMedGoogle Scholar
• Roemer , L. and Orsillo , S. M. 2002 . Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance-based approaches with existing cognitive behavioral models . Clinical Psychology: Science and Practice , 9 : 54 – 68 .
   Web of Science ®Google Scholar
• Roemer , L. , Orsillo , S. M. and Barlow , D. H. 2002 . “ Generalized anxiety disorder ” . In Anxiety and its disorders: The nature and treatment of anxiety and panic , 2nd ed. , Edited by: Barlow , D. H. 477 – 515 . New York : Guilford Press .
   Google Scholar
• Roemer , L. , Salters , K. , Raffa , S. D. and Orsillo , S. M. 2005 . Fear and avoidance of internal experiences in GAD: Preliminary tests of a conceptual model . Cognitive Therapy and Research , 29 : 71 – 88 .
   Web of Science ®Google Scholar
• Rosenthal , M. Z. , Gratz , K. L. , Kosson , D. S. , Cheavens , J. S. , Lejuez , C. W. and Lynch , T. R. 2008 . Borderline personality disorder and emotional responding: A review of the research literature . Clinical Psychology Review , 28 : 75 – 91 .
   PubMed Web of Science ®Google Scholar
• Roussis , P. and Wells , A. 2006 . Post-traumatic stress symptoms: Tests of relationship with thought control strategies and beliefs as predicted by the metacognitive model . Personality and Individual Differences , 40 : 111 – 122 .
   Web of Science ®Google Scholar
• Salters-Pedneault , K. , Roemer , L. , Tull , M. T. , Rucker , L. and Mennin , D. S. 2006 . Evidence of broad deficits in emotion regulation associated with chronic worry and generalized anxiety disorder . Cognitive Therapy and Research , 30 : 469 – 480 .
   Web of Science ®Google Scholar
• Salters-Pedneault , K. , Suvak , M. and Roemer , L. 2008 . An experimental investigation of the effect of worry on responses to a discrimination learning task . Behavior Therapy , 39 : 251 – 261 .
   PubMed Web of Science ®Google Scholar
• Salters-Pedneault , K. , Tull , M. T and Roemer , L. 2004 . The role of avoidance of emotional material in the anxiety disorders . Applied and Preventive Psychology , 11 : 95 – 114 .
   Web of Science ®Google Scholar
• Scarpa , A. , Wilson , L. C. , Wells , A. O. , Patriquin , M. A. and Tanaka , A. 2009 . Thought control strategies as mediators of trauma symptoms in young women with histories of child sexual abuse . Behaviour Research and Therapy , 47 : 809 – 813 .
   PubMed Web of Science ®Google Scholar
• Taylor , C. T. , Laposa , J. M. and Alden , L. E. 2004 . Is avoidant personality disorder more than just social avoidance? . Journal of Personality Disorders , 18 : 571 – 594 .
   PubMed Web of Science ®Google Scholar
• Tull , M. T. , Barrett , H. M. , McMillan , E. S. and Roemer , L. 2007 . A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms . Behavior Therapy , 38 : 303 – 313 .
   PubMed Web of Science ®Google Scholar
• Tull , M. T. , Bornovalova , M. A. , Patterson , R. , Hopko , D. R. and Lejuez , C. W. 2008 . “ Analogue research ” . In Handbook of research methods in abnormal and clinical psychology , Edited by: McKay , D. 61 – 78 . Thousand Oaks, CA : Sage .
   Google Scholar
• Tull , M. T. , Gratz , K. L. , Salters , K. and Roemer , L. 2004 . The role of experiential avoidance in posttraumatic stress symptoms and symptoms of depression, anxiety, and somatization . Journal of Nervous and Mental Disease , 192 : 754 – 761 .
   PubMed Web of Science ®Google Scholar
• Tull , M. T. , Jakupcak , M. , McFadden , M. E. and Roemer , L. 2007 . The role of negative affect intensity and the fear of emotions in posttraumatic stress symptom severity among victims of childhood interpersonal violence . Journal of Nervous and Mental Disease , 195 : 580 – 587 .
   PubMed Web of Science ®Google Scholar
• Weathers , F. W. , Litz , B. T. , Herman , D. S. , Huska , J. A. and Keane , T. M. 1993, October . The PTSD Checklist: Reliability, validity, and diagnostic utility , Paper presented at the annual meeting of the International Society for Traumatic Stress Studies, San Antonio, TX
   Google Scholar
• Wells , A. 2006 . “ The metacognitive model of worry and generalised anxiety disorder ” . In Worry and its psychological disorders; Theory, assessment, and treatment , Edited by: Davey , G. C. L. and Wells , A. 179 – 199 . Hoboken, NJ : Wiley .
   Google Scholar
• Wells , A. and Papageorgiou , C. 1995 . Worry and the incubation of intrusive images following stress . Behaviour Research and Therapy , 33 : 579 – 583 .
   PubMed Web of Science ®Google Scholar