Holly K. Orcutt

Preliminary Psychometric Properties of the Acceptance and Action Questionnaire-II: A Revised Measure of Psychological Inflexibility and Experiential Avoidance

The present research describes the development and psychometric evaluation of a second version of the Acceptance and Action Questionnaire (AAQ-II), which assesses the construct referred to as, variously, acceptance, experiential avoidance, and psychological inflexibility. Results from 2,816 participants across six samples indicate the satisfactory structure, reliability, and validity of this measure. For example, the mean alpha coefficient is .84 (.78-.88), and the 3- and 12-month test-retest reliability is .81 and .79, respectively. Results indicate that AAQ-II scores concurrently, longitudinally, and incrementally predict a range of outcomes, from mental health to work absence rates, that are consistent with its underlying theory. The AAQ-II also demonstrates appropriate discriminant validity. The AAQ-II appears to measure the same concept as the AAQ-I (r=.97) but with better psychometric consistency.

Personality and the predisposition to engage in risky or problem behaviors during adolescence

Longitudinal data from a representative sample of 1,978 Black and White adolescents were used to examine the role of personality in multiple risk or problem behaviors. Results indicate that covariation among diverse behaviors (educational underachievement, delinquent behavior, substance use, sexual behavior) can be adequately modeled by a single higher order factor, and that impulsivity and avoidance coping serve as generalized risk factors for involvement in these behaviors. Whereas none of the personality variables examined explained change in problem behaviors once established, avoidance coping prospectively predicted involvement among a subgroup of adolescents with little or no prior involvement. Results suggest that dysfunctional styles of regulating emotions and emotionally driven behaviors are core features of risky or problem behaviors during adolescence.

Male-perpetrated violence among Vietnam veteran couples: relationships with veteran's early life characteristics, trauma history, and PTSD symptomatology.

Using structural equation modeling, we examined the impact of early-life stressors, war-zone stressors, and PTSD symptom severity on partners reports of recent male-perpetrated intimate partner violence (IPV) among 376 Vietnam veteran couples. Results indicated that several variables demonstrated direct relationships with IPV, including relationship quality with mother, war-zone stressor variables, and PTSD symptom severity. Importantly, retrospective reports of a stressful early family life, childhood antisocial behavior, and war-zone stressors were indirectly associated with IPV via PTSD. One of our 2 war-zone stressor variables, perceived threat, had both direct and indirect (through PTSD) relationships with IPV. Experiencing PTSD symptoms as a result of previous trauma appears to increase an individuals risk for perpetrating IPV. Implications for research and treatment are discussed.

Motivational pathways to alcohol use and abuse among Black and White adolescents

Using data from a biracial community sample of adolescents, the present study examined trajectories of alcohol use and abuse over a 15-year period, from adolescence into young adulthood, as well as the extent to which these trajectories were differentially predicted by coping and enhancement motives for alcohol use among the 2 groups. Coping and enhancement motivations (M. L. Cooper, 1994) refer to the strategic use of alcohol to regulate negative and positive emotions, respectively. Results showed that Black and White youth follow distinct alcohol trajectories from adolescence into young adulthood and that these trajectories are differentially rooted in the regulation of negative and positive emotions. Among Black drinkers, coping motives assessed in adolescence more strongly forecast differences in alcohol involvement into their early 30s, whereas enhancement motives more strongly forecast differences among White drinkers. Results of the present study suggest that different models may be needed to account for drinking behavior among Blacks and Whites and that different approaches may prove maximally effective in reducing heavy or problem drinking among the 2 groups.

Attentional control as a moderator of the relationship between posttraumatic stress symptoms and attentional threat bias

Attentional threat bias (ATB) has been suggested as one factor leading to maintenance and exacerbation of posttraumatic stress symptoms (PTSS). In the present study, attentional processes (i.e., facilitated engagement, difficulty disengaging) underlying the association between ATB and PTSS were examined. Additionally, attentional control (AC) was examined as a moderator of this relationship. Participants (N=97) completed a dot-probe task with two levels of stimulus-onset asynchrony (SOA: 150 and 500ms). Higher PTSS were associated with ATB when SOA was longer (i.e., 500ms), suggesting difficulty disengaging from threat stimuli. AC moderated the relationship between PTSS and ATB when SOA was shorter (i.e., 150ms), with participants high in PTSS and high in AC having disengaged and shifted attention from threat stimuli using top-down AC when the emotional valence of threat stimuli was less salient (i.e., shorter presentation duration). Findings implicate AC as a buffering mechanism against prolonged attentional engagement with threat-related stimuli among those with high PTSS. Current PTSD interventions may benefit from incorporating attention-based components.

Peritraumatic dissociation and experiential avoidance as prospective predictors of posttraumatic stress symptoms.

Peritraumatic dissociation (PD) and experiential avoidance (EA) have been implicated in the etiology of posttraumatic stress symptomatology (PTSS); however, the function of these two factors in the onset and maintenance of PTSS following a potentially traumatic event is unclear. The temporal relationships between EA, PD, and the four clusters of PTSS proposed by the Simms/Watson dysphoria model (Simms, Watson, & Doebbeling, 2002) were examined in a three-wave prospective investigation of 532 undergraduate women participating in an ongoing longitudinal study at the time of a campus shooting. Path analyses indicated that preshooting EA predicted greater PD, intrusions, and dysphoria symptoms approximately one month postshooting. PD was associated with increased symptomatology across all four clusters 1-month postshooting, while 1-month postshooting EA was associated with higher dysphoria and hyperarousal symptoms eight months postshooting. PD had a significant indirect effect on all four PTSS clusters eight months postshooting via 1-month postshooting symptom reports. The results suggest that both EA and PD show unique influences as risk factors for PTSS following a potentially traumatic event.

Female-perpetrated intimate partner violence and romantic attachment style in a college student sample.

The frequency, severity, and reciprocity of female-perpetrated intimate partner violence and its consequences (i.e., injuries) were investigated in a college sample of women (N = 457). Participants were classified into one of the following four groups on the basis of self-reported physical assault perpetration and victimization against their relationship partners: nonviolent, perpetrator-only, victim-only, and bidirectionally violent. Results showed that females in the bidirectionally violent group had a reportedly higher occurrence (although not always statistically significant) of perpetration and victimization than those in the perpetrator-only and victim-only groups. Additionally, a similar degree of reciprocity was indicated by females in bidirectionally violent relationships in terms of violence severity and the occurrence of injury. Adult romantic attachment style was also examined among a subset of females (N = 328), and bidirectionally violent females were found to have the highest reported levels of attachment anxiety. Further, females high in attachment anxiety and low in attachment avoidance were more likely to report perpetrating violence than females high in both styles. Implications for prevention are discussed.

Emotion Regulation and Posttraumatic Stress Symptoms: A Meta-Analysis

Emotion regulation (ER) has been identified as a critical factor in the development and maintenance of posttraumatic stress symptoms (PTS; Bardeen, Kumpula, & Orcutt, 2013 [Journal of Anxiety Disorders, 27, 188–196]; Marx & Sloan, 2005 [Behaviour Research and Therapy, 43, 569–583]; Nightingale & Williams, 2000 [British Journal of Clinical Psychology, 39, 243–254]). The current meta-analysis aimed to provide a thorough, quantitative examination of the associations between PTS and several aspects of ER. A search of the PsychINFO database resulted in 2557 titles, of which 57 met full inclusion criteria (the cross-sectional association between PTS symptoms and ER was reported, participants were 18 years or older, the article was written in English, and sufficient information was reported to calculate effect sizes). From the 57 studies that were included, 74 effect sizes were obtained. All studies were independently coded by two of the study authors for the following: citation, sample type, total N size (and group ns if applicable), mean age of participants, type of traumatic event, study design, PTS measure(s), ER measure(s), and effect size information. Eight random effects models were conducted: seven for individual ER strategies (e.g., rumination) and one for general emotion dysregulation. The largest effects were observed for general emotion dysregulation (r = 0.53; k = 13), rumination (r = 0.51; k = 5), thought suppression (r = 0.47; k = 13), and experiential avoidance (r = 0.40; k = 20). Medium effects were observed for expressive suppression (r = 0.29; k = 3) and worry (r = 0.28; k = 6). Significant effects were not observed for acceptance or reappraisal. Moderator analyses (sample and trauma type) were conducted for general emotion dysregulation, experiential avoidance, and thought suppression; no significant differences were observed. Findings from the current analysis suggest that several aspects of ER are associated with PTS symptoms across a variety of samples. Additionally, the current study highlights a number of limitations in the existing ER and PTS symptom literature.

The Prospective Relationship of Interpersonal Forgiveness and Psychological Distress Symptoms among College Women.

Forgiveness has frequently been theorized to be related to decreased psychological distress, and longitudinal survey research is important for the examination of this relationship. The prospective relation of forgiveness to psychological distress symptoms (i.e., depression, anxiety, and stress) at a later time point (an average of 36 weeks later) was examined in a sample of 182 female undergraduate students. Through use of structural equation modeling, it was observed that offense-specific (as compared with dispositional) forgiveness toward an offender of a self-identified interpersonal transgression was significantly negatively related to psychological distress symptoms at Time 2, above and beyond the impact of symptom levels at Time 1. Perceived severity and time since the offense at Time 1 were examined as possible moderators of this relationship; time since offense was found to moderate the relationship between forgiveness and change in psychological distress symptoms between Time 1 and Time 2. Implications for acceptance-based interventions and prevention of psychopathology are discussed.

Experiential Avoidance as a Mediator in the Relationship Between Childhood Psychological Abuse and Current Mental Health Symptoms in College Students

ABSTRACT Psychological abuse in childhood has been linked to psychological distress in adulthood, although the interceding variables or possible mediators for the adult distress have not been adequately examined. Identification of mediating variables may provide important opportunities for targeting intervention and prevention efforts following psychological abuse. Experiential avoidance, a response style characterized by avoidance of negative private events, was examined as a potential mediator of the relationship between reports of childhood psychological abuse and current mental health symptoms in a cross-sectional sample of 987 college undergraduates. Utilizing structural equation modeling techniques, experiential avoidance was found to significantly mediate the relationship between childhood psychological abuse and current mental health symptoms, reducing the direct effect by 77%. A history of childhood psychological abuse was related to increased levels of experiential avoidance and current mental health symptoms, and experiential avoidance was also directly related to increased levels of current mental health symptoms. Implications for treatment following psychological abuse are discussed.