Experiential Avoidance, Posttraumatic Stress Disorder, and Self-Injurious Thoughts and Behaviors: A Moderation Analysis in a National Veteran Sample

• Published in: International journal of cognitive therapy 2023-09, Vol.16 (3), p.340-355
• Main Authors: 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.
• Format: Article
• Language: English
• Subjects: Avoidance behavior; Behavioral Science and Psychology; Behavioral Therapy; Clinical Psychology; Compensation plans; Endorsements; Mental depression; Mental disorders; Mental health; Moderation; Persian Gulf War; Post traumatic stress disorder; Prevention; Psychology; Self injury; Suicidal behavior; Suicidal ideation; Suicide; Suicides & suicide attempts; Trauma; Veterans
• ISSN: 1937-1209; 1937-1217; 1937-1217
• 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 ( N  = 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 ( AOR  = 0.96), past-year NSSI ( AOR  = 1.03), and suicide attempts ( AOR  = 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.