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Fear and avoidance of internal experiences among patients with substance use disorders and PTSD: The centrality of anxiety sensitivity

✍ Scribed by Tracy Simpson; Matthew Jakupcak; Jane A. Luterek


Publisher
Springer
Year
2006
Tongue
English
Weight
129 KB
Volume
19
Category
Article
ISSN
0894-9867

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✦ Synopsis


This study evaluated anxiety sensitivity, cognitive avoidance, and alexithymia and their relationship to posttraumatic stress disorder (PTSD) and alcohol use indices concurrently and prospectively in an outpatient substance abuse treatment sample that screened positive for PTSD (N = 58). Anxiety sensitivity accounted for substantial variance in the PTSD clusters, reexperiencing, avoidance, and hyperarousal, both concurrently and prospectively. Cognitive avoidance accounted for additional variance with concurrent PTSD avoidance symptoms. Anxiety sensitivity and cognitive avoidance were largely not associated with alcohol use indices. Alexithymia was largely redundant with cognitive avoidance and was, therefore, not included in the regression analyses. Theoretical and treatment implications of these findings are discussed in the context of individuals with dually diagnosed PTSD and substance abuse disorders.

Avoidance behaviors are common across psychiatric disorders. The fear and subsequent avoidance of thoughts and emotions has been postulated to exacerbate individuals' experience of symptoms and maintain impairment (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996). By definition, people with posttraumatic stress disorder (PTSD) frequently avoid thoughts, feelings, people, and places that are reminders of trauma experiences. This avoidance can take the form of conscious efforts to distract from uncom-