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Yan Y, Chen Y, Ou M, Gong Y, Yang R, Liu X, Xia W, Chen F, Zheng H, Xu X. The mediating role of meaning in life between experiential avoidance and death anxiety among cancer patients: a cross-sectional study. BMC Cancer 2024; 24:663. [PMID: 38822257 PMCID: PMC11141075 DOI: 10.1186/s12885-024-12433-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/27/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Death anxiety is thought to cause a range of mental disorders among cancer patients, which may affect their mental health and even quality of life. This study sought to investigate experiential avoidance, meaning in life, and death anxiety among Chinese cancer patients and then explore the relationship between these 3 variables. METHODS A total of 300 cancer patients recruited from a tertiary cancer hospital participated in this study from October to December 2021. A cross-sectional survey was conducted using a demographic and clinical characteristics questionnaire, the Acceptance and Action Questionnaire II, the Meaning in Life Questionnaire, and Templer's Death Anxiety Scale. Correlation analysis, hierarchical regression analysis, and mediating effect analysis were used to analyze the relationship among experiential avoidance, meaning in life (including 2 dimensions: presence of meaning and search for meaning), and death anxiety. RESULTS A total of 315 questionnaires were distributed, and 300 valid questionnaires were returned, resulting in a valid response rate of 95.2%. Experiential avoidance (r = 0.552, p < 0.01) was moderately positively correlated with death anxiety. Presence of meaning (r = - 0.400, p < 0.01) was moderately negatively correlated with death anxiety, while search for meaning (r = - 0.151, p < 0.01) was weakly negatively correlated with death anxiety. Regression analysis showed that experiential avoidance (β = 0.464) and presence of meaning (β = -0.228) were predictors of death anxiety. Mediating effect analysis revealed that presence of meaning either completely or partially mediated the effect of experiential avoidance and death anxiety, and the indirect effect accounted for 14.52% of the total effect. CONCLUSION Overall, experiential avoidance predicts death anxiety in cancer patients, and meaning in life can mediate this effect. The results of this study provide a new path for studying the mechanism of death anxiety and suggest a more positive and promising strategy for its management.
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Affiliation(s)
- Yixia Yan
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/ Hunan Cancer Hospital, Changsha, Hunan, China
| | - Yongyi Chen
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/ Hunan Cancer Hospital, Changsha, Hunan, China
| | - Meijun Ou
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/ Hunan Cancer Hospital, Changsha, Hunan, China
| | - Youwen Gong
- School of Nursing, University of South China, Hengyang, Hunan, China
| | - Renting Yang
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/ Hunan Cancer Hospital, Changsha, Hunan, China
| | - Xiangyu Liu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/ Hunan Cancer Hospital, Changsha, Hunan, China
| | - Wanting Xia
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Furong Chen
- School of Nursing, University of South China, Hengyang, Hunan, China
| | - Hongling Zheng
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Xianghua Xu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/ Hunan Cancer Hospital, Changsha, Hunan, China.
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Chiu HTS, Low DCW, Chan AHT, Meiser-Stedman R. Relationship between anxiety sensitivity and post-traumatic stress symptoms in trauma-exposed adults: A meta-analysis. J Anxiety Disord 2024; 103:102857. [PMID: 38507961 DOI: 10.1016/j.janxdis.2024.102857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/21/2023] [Accepted: 03/07/2024] [Indexed: 03/22/2024]
Abstract
Given the high rate of trauma exposure among the general population, it is important to delineate the risk factors for post-traumatic stress disorder (PTSD). While historically implicated in panic disorder, anxiety sensitivity is increasingly found to play a role in PTSD. The present review investigated the size of the relationship between anxiety sensitivity and PTSD symptoms among trauma exposed adults. A systematic search on multiple electronic databases (PTSDpubs, CINAHL, MEDLINE and PsycINFO) generated a total of 1025 records, among which 52 (n = 15173) met study inclusion criteria and were included in our random effects meta-analysis. Our results indicated a medium effect size (r = .46, 95% CI =.41,.50) for the relationship between anxiety sensitivity and PTSD symptoms. There was significant between-study heterogeneity. Furthermore, sub-group analyses revealed that study design (cross-sectional vs. longitudinal) may significantly moderate the association between anxiety sensitivity and PTSD severity. No moderation effect was found for assessment of PTSD through interview versus questionnaire, interpersonal versus non-interpersonal trauma, or low versus high study quality. Such patterns of results are consistent with cognitive models of PTSD. Clinical implications, strengths and limitations of the review were discussed.
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Affiliation(s)
- Henry Tak Shing Chiu
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
| | - Debbie Chi Wing Low
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Angel Hiu Tung Chan
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
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3
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Clauss K, Gorday JY, Bardeen JR. Investigating the specific domains of the cognitive attentional syndrome that predict posttraumatic stress symptoms: The moderating effect of attentional control. J Anxiety Disord 2023; 94:102670. [PMID: 36701955 DOI: 10.1016/j.janxdis.2023.102670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 11/08/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
The metacognitive model of posttraumatic stress disorder (PTSD) suggests that persistent use of the maladaptive self-regulation strategies that comprise the cognitive attentional syndrome (CAS) increases the likelihood of developing PTSD symptoms following trauma exposure. The metacognitive model also suggests that flexible regulation of attention might be protective against developing maladaptive outcomes that are associated with the CAS. The aims of this study were to (1) examine associations between all seven domains of the CAS and PTSD symptoms using a recently developed, multidimensional measure of the CAS, and (2) examine the moderating effect of self-reported attentional control on associations between the CAS and PTSD symptoms. Participants were trauma-exposed community adults (N = 237) who completed a battery of self-report measures. Results from linear regression analyses showed that worry, substance use, and internal threat monitoring accounted for unique variance in PTSD symptoms when all seven CAS domains were entered into the same model. Moderation analyses showed that attentional control dampened the effect of the CAS, specifically external threat monitoring, on PTSD symptoms. Study results support attentional control as a protective factor against the maladaptive effects of the CAS on PTSD symptoms.
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Affiliation(s)
- Kate Clauss
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Julia Y Gorday
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA
| | - Joseph R Bardeen
- Department of Psychological Sciences, Auburn University, Auburn, AL, USA.
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4
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Reyes AT, Cross CL, Manzano ERM. The Moderating Role of Resilience on Mindfulness, Experiential Avoidance, and Posttraumatic Stress Disorder (PTSD) Symptoms of College Student Veterans: A Cross-Sectional Study. Issues Ment Health Nurs 2022; 43:721-729. [PMID: 35285759 DOI: 10.1080/01612840.2022.2051104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of the study was to investigate the moderating effect of resilience on the relationship between mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptom severity. A cross-sectional study design was used on a sample of 133 college student military veterans. We found a direct effect of mindfulness on PTSD and a significant mediating effect of experiential avoidance on the relationship between mindfulness and PTSD. Resilience also had a significant moderating effect on the relationship between mindfulness and PTSD. This study provides preliminary evidence on the usefulness of integrating resilience development in mindfulness-based interventions for trauma-related disorders.
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Affiliation(s)
| | - Chad L Cross
- School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada, USA
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5
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Larrazabal MA, Naragon-Gainey K, Conway CC. Distress Tolerance and Stress-induced Emotion Regulation Behavior. JOURNAL OF RESEARCH IN PERSONALITY 2022. [DOI: 10.1016/j.jrp.2022.104243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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6
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Reyes AT, Song H, Bhatta TR, Kearney CA. Exploring the relationships between resilience, mindfulness, and experiential avoidance after the use of a mindfulness- and acceptance-based mobile app for posttraumatic stress disorder. Perspect Psychiatr Care 2022; 58:776-784. [PMID: 34018197 DOI: 10.1111/ppc.12848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/23/2021] [Accepted: 05/02/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study used a mindfulness- and acceptance-based mobile app to examine the relationships between resilience, mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptoms. DESIGN AND METHODS A quasi-experimental pre-posttest, single-group study design was used. A total of 23 college student veterans used the app for 4 weeks. Outcomes of resilience, mindfulness, experiential avoidance, and PTSD were measured at three time-points (baseline, end of Week 2, and end of Week 4). FINDINGS All outcomes significantly improved at postintervention. Improvements in resilience and PTSD significantly correlated with improvement in mindfulness. PRACTICE IMPLICATIONS Mindfulness- and acceptance-based mobile apps can be safely used by individuals with PTSD as a complementary approach to enhance resilient coping with PTSD.
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Affiliation(s)
- Andrew T Reyes
- School of Nursing, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Huaxin Song
- School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Tirth R Bhatta
- Department of Sociology, University of Nevada Las Vegas, Las Vegas, Nevada, USA
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7
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Saulnier KG, Allan NP, Judah MR, Koscinski B, Hager NM, Albanese B, Knapp AA, Schmidt NB. Attentional Control Moderates the Relations between Intolerance of Uncertainty and Generalized Anxiety Disorder and Symptoms. COGNITIVE THERAPY AND RESEARCH 2021; 45:1193-1201. [PMID: 34720260 PMCID: PMC8553219 DOI: 10.1007/s10608-021-10223-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Intolerance of uncertainty (IU), perceived attentional control (AC), and poor cognitive control abilities are risk factors for anxiety; however, few studies have examined their interactive effects in relation to anxiety. A more complete understanding of interplay between IU, perceived AC, and cognitive control could inform intervention efforts. METHODS The current study examined the direct and interactive effects of IU and AC on anxiety in a sample of 280 community outpatients (M age = 36.01 years, SD = 16.17). Perceived AC was measured using self-report and cognitive control abilities were measured using a Go/No-Go task. RESULTS Findings indicated a significant IU by perceived AC interaction predicting worry and GAD diagnoses. There was a positive relation between IU and worry/GAD diagnoses that was strongest among those with high perceived AC. Perceived AC was unrelated to cognitive control abilities, and cognitive control abilities did not interact significantly with IU. Cognitive control abilities were related to worry symptoms but not to GAD diagnoses. CONCLUSIONS These results indicate that at high levels of perceived AC, individuals with elevated IU report higher levels of worry, potentially due to the conscious use of worry as an emotion regulation strategy. Clinical implications and future directions are discussed.
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Affiliation(s)
| | | | - Matt R. Judah
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | | | - Nathan M. Hager
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | - Brian Albanese
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Ashley A. Knapp
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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8
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Jessup SC, Cox RC, Olatunji BO. Differential effects of attentional control domains on the association between rumination and PTSD symptoms in trauma exposed veterans. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2021.110886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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9
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Bardeen JR, Gorday JY, Clauss K. The Moderating Effect of Attentional Control on the Relationship Between COVID Stress and Generalized Anxiety Symptoms. Psychol Rep 2021; 125:2517-2530. [PMID: 34120535 DOI: 10.1177/00332941211025260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The recent global pandemic (i.e., COVID-19) has had a serious impact on psychological health, as the stress associated with the pandemic increases the likelihood of developing clinically significant anxiety. Evidence suggests that attentional control may protect those individuals with outcome-specific vulnerabilities from developing maladaptive psychological outcomes. In the present study, attentional control was examined as a moderator of the relation between COVID-19 stress and generalized anxiety symptoms in a community sample (N = 359 adults). As predicted, the relationship between COVID-19 stress and anxiety was moderated by attentional control. Specifically, as attentional control decreased, the strength of the association between COVID-19 stress and anxiety increased. The results suggest that, among those with higher levels of COVID-19 stress, attentional control may act as a protective factor against developing anxiety. It may be beneficial as a matter of standard public health guidance to recommend that the general public engages in activities that are known to improve attentional control and alleviate emotional distress (e.g., mindfulness-based techniques) at the outset of a pandemic or other global catastrophe to reduce the likelihood that prolonged event-related stress will lead to impairing anxiety.
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Affiliation(s)
- Joseph R Bardeen
- Department of Psychological Sciences, 1383Auburn University, USA
| | - Julia Y Gorday
- Department of Psychological Sciences, 1383Auburn University, USA
| | - Kate Clauss
- Department of Psychological Sciences, 1383Auburn University, USA
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10
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Anxiety Sensitivity and Distress Tolerance Predict Changes in Internalizing Symptoms in Individuals Exposed to Interpersonal Trauma. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10234-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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González-Hernández J, López-Mora C, Yüce A, Nogueira-López A, Tovar-Gálvez MI. "Oh, My God! My Season Is Over!" COVID-19 and Regulation of the Psychological Response in Spanish High-Performance Athletes. Front Psychol 2021; 12:622529. [PMID: 33841254 PMCID: PMC8024472 DOI: 10.3389/fpsyg.2021.622529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/08/2021] [Indexed: 11/21/2022] Open
Abstract
Background: In an unprecedented situation of interruption of the sporting dynamics, the world of sport is going through a series of adaptations necessary to continue functioning despite coronavirus disease 2019 (COVID-19). More than ever, athletes are facing a different challenge, a source of discomfort and uncertainty, and one that absolutely alters not only sports calendars, but also trajectories, progressions, and approaches to sports life. Therefore, it is necessary to identify the levels of psychological vulnerability that may have been generated in the athletes, because of the coexistence with dysfunctional responses during the COVID-19 experience, and which directly influence the decrease of their mental health. Methods: With a descriptive and transversal design, the study aims to identify the state of the dysfunctional psychological response of a sample of Spanish athletes (N = 284). The DASS-21 (Depression, Anxiety, and Stress Scale), Toronto-20 (alexithymia), and Distress Tolerance Scale questionnaires were administered to a sample of high-level Spanish athletes in Olympic programs. Results: The results suggest that the analyzed athletes indicate high levels of dysfunctional response (e.g., anxiety, stress, depression, and alexithymia) when their tolerance is low. In addition, the variables show less relational strength, when the capacity of tolerance to distress is worse and age is lower. At the same time, the greater the anxiety and uncertainty are, leading to more catastrophic and negative thoughts, the younger the athletes are. Conclusions: It is clear that both age and tolerance to distress are considered adequate protective factors for psychological vulnerability in general and for associated dysfunctional responses in particular. Moreover, the psychological resources offered by more experienced athletes are also a guarantee of protection against negativity and catastrophism.
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Affiliation(s)
- Juan González-Hernández
- Health Psychology/Behavioural Medicine, Research Group (CTS−0267), University of Granada, Granada, Spain
| | - Clara López-Mora
- Human Development and Family Science, University of Missouri-Columbia, Columbia, MO, United States
| | - Arif Yüce
- Department of Sports Management, Faculty of Sports Science, Eskisehir Technical University, Eskisehir, Turkey
| | - Abel Nogueira-López
- Department of Health and Sport, European University of the Atlantic, Santander, Spain
- Department of Health and Sport, International Ibero-American University, Campeche, Mexico
- Department of Health and Sport, International University of Cuanza, Cuito, Angola
| | - Maria Isabel Tovar-Gálvez
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
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12
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Gharehgazlou A, Richardson JD, Jetly R, Dunkley BT. Cortical gyrification morphology in PTSD: A neurobiological risk factor for severity? Neurobiol Stress 2021; 14:100299. [PMID: 33659579 PMCID: PMC7890044 DOI: 10.1016/j.ynstr.2021.100299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/05/2021] [Accepted: 01/18/2021] [Indexed: 12/20/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a prevalent psychiatric disorder, particularly among military personnel and veterans. Cortical gyrification, as a specific metric derived from structural MRI, is an index of the convoluted folding and patterning of the gyri and sulci, and is thought to facilitate the efficiency of local neuronal wiring. It has the potential to act as a neurobiological risk factor for emergent psychiatric disorders – to date, it has been understudied in PTSD. Here, using a local measure of the degree of gyrification (local Gyrification Index, lGI) we investigate cortical gyrification morphology in 48 adult male soldiers with (n = 23) and without (n = 25) a PTSD diagnosis. We also examine the relation between lGI and PTSD severity within the PTSD group. General linear models yielded significant between-group differences with greater lGI found in PTSD in a cluster located in the medial occipito-parietal lobe on the left hemisphere and reduced lGI in a cluster located on the lateral surface of the parietal lobe on the right hemisphere. Brain-behaviour analyses within the PTSD group yielded significant positive associations between lGI and PTSD severity in a cluster located in the frontal cortex of the left hemisphere and scattered clusters located within all lobes of the right hemisphere. After accounting for the effects of comorbid psychiatric symptoms common in PTSD, the associations in the right hemisphere reduced to clusters only located in the frontal lobe, while the cluster in the left hemisphere remained significant. Our results suggest that atypical cortical gyrification in parietal and occipital regions may be implicated in the psychopathology of PTSD diagnosis, and properties of prefrontal gyrification associated with the emergent severity of PTSD after trauma. The importance of these regions in PTSD may be attributed to a pre-existing neurobiological risk factor, or neuromorphological changes after trauma precipitating emergent psychiatric illness. Our brain-behaviour relations provide support for the existing literature by highlighting the importance of the frontal lobe in the pathogenesis of PTSD. Future large-scale longitudinal studies including female participants may infer causal implications of atypical gyrification in PTSD and shed light on the potential effect of sex on this brain metric.
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Affiliation(s)
- Avideh Gharehgazlou
- Neurosciences & Mental Health, The Hospital for Sick Children (SickKids) Research Institute, Toronto, Ontario, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - J Don Richardson
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Operational Stress Injury Clinic, St. Joseph's Health Care, London, Ontario, Canada
| | - Rakesh Jetly
- Canadian Forces Health Services Group HQ, Department of National Defence, Ottawa, Ontario, Canada
| | - Benjamin T Dunkley
- Neurosciences & Mental Health, The Hospital for Sick Children (SickKids) Research Institute, Toronto, Ontario, Canada.,Department of Diagnostic Imaging, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
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13
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Preston TJ, Morabito DM, Albanese BJ, Schmidt NB. Distress intolerance mediates attentional control on posttraumatic stress symptoms: Evidence from two clinical samples. J Psychiatr Res 2020; 130:447-454. [PMID: 32911357 DOI: 10.1016/j.jpsychires.2020.06.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/18/2020] [Accepted: 06/24/2020] [Indexed: 10/23/2022]
Abstract
Theoretical models emphasize the importance of both affective and cognitive risk factors in the development of posttraumatic stress symptoms (PTSS). Two such factors predicting PTSS have been studied extensively: distress intolerance (DI) - an affective factor indicative of the ability to tolerate negative affective states - and attentional control (AC), a cognitive factor reflecting the ability to flexibly shift and maintain attention to goal-relevant tasks. Previous work primarily highlights the independent contributions of DI and AC and their interaction to predict PTSS. Some models, however, suggest a mediational pathway such that AC indirectly affects PTSS via diminished DI. The current paper addressed this gap by first attempting to replicate prior findings, while also exploring this mediation model. Results were examined in two clinical samples - a trauma-exposed sample of adults (study 1; N = 73) and trauma-exposed treatment-seeking adults (study 2; N = 204). Results partially supported our hypotheses; both studies failed to replicate prior moderation findings, but our mediational hypothesis was supported in both samples. Low AC appears to decrease an individual's tolerance for distressing situations, which in turn increases the severity of PTSS. Results suggest that PTSD treatments may benefit by incorporating components of AC, DI, or a combination of the two to mitigate PTSS. Taken together, this study provides a novel examination of how cognitive and affective risk factors, namely AC and DI, work in tandem to increase PTSS.
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14
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Thomas KN, Bardeen JR. The buffering effect of attentional control on the relationship between cognitive fusion and anxiety. Behav Res Ther 2020; 132:103653. [PMID: 32544636 DOI: 10.1016/j.brat.2020.103653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 05/19/2020] [Accepted: 05/25/2020] [Indexed: 12/30/2022]
Abstract
Cognitive fusion has been identified as a risk factor for anxiety. Evidence suggests that those with better attentional control may be able to flexibly shift attention from an internal to external focus, thus reducing contact with negative self-referent thoughts. As such, attentional control was examined as a moderator of the relation between cognitive fusion and anxiety in this two-part study. Adult participants (N = 597) completed self-report measures in Study 1. In Study 2, adult student participants (N = 173) completed self-report measures of cognitive fusion and anxiety, as well as behavioral measures that assessed three specific attentional control processes (i.e., inhibition, shifting, working memory updating). As predicted, attentional control moderated the relation between cognitive fusion and anxiety such that the strength of the relation decreased as attentional control increased. The results of Study 2 suggest that inhibitory ability is the attentional control process that accounts for this effect. Taken together, results suggest the possibility that attentional control (especially inhibitory ability) may be a protective factor against the development of anxiety among those with higher levels of cognitive fusion. The use of experimental and longitudinal study designs will be an important next step in this line of research to further clarify the nature of relations among cognitive fusion, attentional control, and anxiety. Results from an exploratory analysis, in which depressive symptoms served as the outcome variable, will also be discussed.
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15
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Kelso KC, Kashdan TB, Imamoğlu A, Ashraf A. Meaning in life buffers the impact of experiential avoidance on anxiety. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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A Bifactor Model of the Straightforward Attentional Control Scale. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019. [DOI: 10.1007/s10862-019-09737-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Bardeen JR, Fergus TA. Executive Control Deficits Potentiate the Effect of Maladaptive Metacognitive Beliefs on Posttraumatic Stress Symptoms. Front Psychol 2018; 9:1898. [PMID: 30349499 PMCID: PMC6186835 DOI: 10.3389/fpsyg.2018.01898] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/18/2018] [Indexed: 12/04/2022] Open
Abstract
The metacognitive model and recent preliminary research suggests that metacognitive beliefs (i.e., beliefs about thinking) may be particularly important for understanding the pathogenesis of posttraumatic stress (PTS). The metacognitive model also suggests that deficits in executive control (i.e., metacognitive control) may increase the impact of metacognitive beliefs on PTS symptoms. Trauma-exposed adult participants (N = 469), recruited through an online crowdsourcing website, completed a battery of measures assessing the constructs of interest. As predicted, deficits in executive control strengthened the positive association between metacognitive beliefs and PTS symptoms. This effect was found in relation to positive (e.g., "Worrying will keep me safe"), but not negative (e.g., "My thoughts are uncontrollable"), metacognitive beliefs. Supplemental analyses, indicated that the interaction between positive metacognitive beliefs and executive control significantly predicted all PTS cluster scores (i.e., Intrusion, Cognition, Arousal, Avoidance). Taken together, results support the proposal that executive control deficits potentiate the effect of metacognitive beliefs on PTS symptoms. Intervention strategies designed to strengthen executive control (e.g., the attention training technique) may be useful in treating individuals with PTS.
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Affiliation(s)
- Joseph R. Bardeen
- Department of Psychology, Auburn University, Auburn, AL, United States
| | - Thomas A. Fergus
- Baylor Psychology and Neuroscience Department, Baylor University, Waco, TX, United States
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18
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Clayson KA, Bardeen JR, Dolan SL, Fergus TA. Executive attention moderates the effect of trait anxiety on hyperarousal symptoms. Cogn Behav Ther 2018; 48:311-321. [PMID: 30117379 DOI: 10.1080/16506073.2018.1506819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The majority of individuals exposed to trauma do not go on to develop posttraumatic stress disorder (PTSD); thus, researchers have sought to identify individual difference variables that make one particularly susceptible to posttraumatic stress symptoms. Trait anxiety is one individual difference variable implicated in the pathogenesis of posttraumatic stress symptoms. Following from cognitive theories of anxiety and extant data, the purpose of the present study was to examine executive attention as a moderator of the relation between trait anxiety and posttraumatic stress symptoms, particularly hyperarousal symptoms, among undergraduate women reporting trauma exposure (N = 88). As predicted, executive attention moderated the association between trait anxiety and hyperarousal symptoms, such that there was a significantly weaker relation as executive attention increased. Study results further support the potential buffering effect of executive attention in relation to posttraumatic stress symptoms, as well as the possible importance of targeting executive attention following trauma exposure.
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Affiliation(s)
- Kelsi A Clayson
- a Department of Psychology and Neuroscience , Baylor University , Waco , TX , USA
| | - Joseph R Bardeen
- b Department of Psychology , Auburn University , Auburn , AL , USA
| | - Sara L Dolan
- a Department of Psychology and Neuroscience , Baylor University , Waco , TX , USA
| | - Thomas A Fergus
- a Department of Psychology and Neuroscience , Baylor University , Waco , TX , USA
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Albanese BJ, Macatee RJ, Boffa JW, Bryan CJ, Zvolensky MJ, Schmidt NB. Interactive effects of traumatic brain injury and anxiety sensitivity on PTSD symptoms: A replication and extension in two clinical samples. COGNITIVE THERAPY AND RESEARCH 2018; 42:510-523. [PMID: 29881128 PMCID: PMC5986097 DOI: 10.1007/s10608-017-9883-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Brian J Albanese
- Department of Psychology, Florida State University, Tallahasssee, FL, USA
| | - Richard J Macatee
- Department of Psychology, Florida State University, Tallahasssee, FL, USA
| | - Joseph W Boffa
- Department of Psychology, Florida State University, Tallahasssee, FL, USA
| | - Craig J Bryan
- National Center for Veterans Studies, Salt Lake City, UT, USA
- Department of Psychology, University of Utah, UT, USA
| | | | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahasssee, FL, USA
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Rogers TA, Bardeen JR, Fergus TA, Benfer N. Factor Structure and Incremental Utility of the Distress Tolerance Scale: A Bifactor Analysis. Assessment 2018; 27:297-308. [PMID: 30027747 DOI: 10.1177/1073191118789496] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Distress Tolerance Scale (DTS) is a self-report measure of perceived capacity to withstand aversive emotions. Initial factor analysis of this measure suggested a structure comprising one higher-order factor and four lower-order domain-specific factors. However, there is limited evidence in support of the DTS's purported multidimensionality, and despite use of the DTS subscales, research has yet to assess their incremental utility. The current investigation sought to rectify the paucity of evidence in support of the DTS's factor structure and independent use of DTS subscales via bifactor analysis. In the present study (N = 826 community adults), a bifactor model of the DTS provided the best fit to the data. However, an examination of statistical indices associated with bifactor modeling, as well as results from an examination of incremental utility, suggest that the domain-specific factors are largely redundant with the general factor and do not provide incremental utility in predicting relevant clinical constructs beyond the general factor. Measurement invariance between sexes was confirmed. Taken together, results support use of a DTS total score, but not subscale scores.
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Albanese BJ, Macatee RJ, Allan NP, Short NA, Norr AM, Schmidt NB. Interactive effects of Anxiety Sensitivity and Attentional Control on Post-traumatic Stress in Community and Clinical Populations. Psychiatry 2018; 81:71-84. [PMID: 29565729 PMCID: PMC5970032 DOI: 10.1080/00332747.2017.1309867] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE High anxiety sensitivity (AS) and poor attention control (AC) are established risk factors for posttraumatic stress symptoms (PTSS), but little is known about the combined influence of these variables. Consistent with dual-systems models suggesting facets of executive function (e.g., AC) will modulate the effects of other risk factors (e.g., AS), the current study evaluated the singular and interactive effects of these variables on posttraumatic stress disorder (PTSD) symptoms. METHOD In Study 1, latent variable modeling was used to examine the unique and interactive effects of AS and AC on PTSS, controlling for trauma history, sex, and age, in a sample of trauma-exposed community adults (N = 670). In Study 2, latent variable modeling was used to replicate these effects in a sample of trauma-exposed treatment-seeking adults (N = 207). RESULTS Findings from both studies demonstrated a significant and negative interaction between AS and AC predicting PTSS when controlling for trauma history, sex, and age. Moreover, results revealed that AS more strongly predicts PTSS among those with poor AC. CONCLUSIONS These findings suggest that impaired AC, one facet of executive function, may potentiate the effects of AS on PTSS, and increasing levels of AS may enhance the effects of AC on PTSS. Results are discussed within the context of a dual-systems model of PTSS.
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Affiliation(s)
- Brian J. Albanese
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
| | - Richard J. Macatee
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
| | | | - Nicole A. Short
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
| | - Aaron M. Norr
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahasssee, FL 32306-4301, USA
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Della Longa NM, De Young KP. Experiential avoidance, eating expectancies, and binge eating: A preliminary test of an adaption of the Acquired Preparedness model of eating disorder risk. Appetite 2018; 120:423-430. [DOI: 10.1016/j.appet.2017.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/16/2017] [Accepted: 09/21/2017] [Indexed: 10/18/2022]
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O'Bryan EM, Kraemer KM, Johnson AL, McLeish AC, McLaughlin LE. Examining the role of attentional control in terms of specific emotion regulation difficulties. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.12.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Cox RC, Olatunji BO. Linking attentional control and PTSD symptom severity: the role of rumination. Cogn Behav Ther 2017. [DOI: 10.1080/16506073.2017.1286517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rebecca C. Cox
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37240, USA
| | - Bunmi O. Olatunji
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37240, USA
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Young G. PTSD in Court II: Risk factors, endophenotypes, and biological underpinnings in PTSD. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2017; 51:1-21. [PMID: 28262266 DOI: 10.1016/j.ijlp.2017.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 02/06/2017] [Indexed: 06/06/2023]
Abstract
The second article in the series of three for the journal on "PTSD in Court" especially concerns the biological bases that have been found to be associated with PTSD (posttraumatic stress disorder). The cohering concepts in this section relate to risk factors; candidate genes; polygenetics; "gene×environment" interactions; epigenetics; endophenotypes; biomarkers; and connective networks both structurally and functionally (in terms of intrinsic connectivity networks, ICNs, including the DMN, SN, and CEN; that is, default mode, salience, and central executive networks, respectively). Risk factors related to PTSD include pre-event, event- and post-event ones. Some of the genes related to PTSD include: FKBP5, 5-HTTLPR, and COMT (which are, respectively, FK506-binding protein 5 gene, serotonin-transporter linked polymorphic region, catechol-O-methyl-transferase). These genetic findings give an estimate of 30% for the genetic influence on PTSD. The typical brain regions involved in PTSD include the amygdala, hippocampus, and prefrontal cortex, along with the insula. Causal models of behavior are multifactorial and biopsychosocial, and these types of models apply to PTSD, as well. The paper presents a multilevel systems model of psychopathology, including PTSD, which involves three levels - a top-down psychological construct one, a bottom-up symptom connection one, and a middle one involving symptom appraisal. Legally, causality refers to the event at issue needing to meet the bar of being materially contributory to the outcome. Finally, this section of the article reviews empirically-supported therapies for PTSD and the dangers of not receiving treatment for it.
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Affiliation(s)
- Gerald Young
- Glendon Campus, York University, Toronto, Ontario, Canada.
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