Psychological Development and Education ›› 2022, Vol. 38 ›› Issue (5): 683-691.doi: 10.16187/j.cnki.issn1001-4918.2022.05.09

Previous Articles     Next Articles

The Mediating Effects of Experiential Avoidance and Negative Cognitive Emotion Regulation Strategies on the Relationship between Cumulative Traumatic Experiences and Complex Posttraumatic Stress Disorders in Children

LI Jina1,2, WANG Weiwei3, ZHANG Weijun1,2, QU Zhiyong1,2   

  1. 1. School of Social Development and Public Policy, Beijing Normal University, Beijing 100875;
    2. Center for Behavioral Health, Beijing Normal University, Beijing 100875;
    3. School of Sociology and Population Studies, Renmin University of China, Beijing 100872
  • Published:2022-09-14

Abstract: This study aimed to explore the underlying mechanism between cumulative traumatic experiences and complex posttraumatic stress disorders (CPTSD). Using the convenience sampling method, a total of 3478 traumatized children in grades 4~5 from 7 primary schools in Henan province were selected. All participants completed questionnaires regarding the Traumatic Experiences Checklist, the Behavioral Activation for Depression Scale-Short Form, the Cognitive Emotion Regulation Questionnaire-Short Form and the International Trauma Questionnaire. The results showed that:(1) cumulative traumatic experiences, experiential avoidance, and negative cognitive emotion regulation strategies were significantly associated with CPTSD. Besides, cumulative traumatic experiences positively predicted children's CPTSD; (2) experiential avoidance and negative cognitive emotion regulation strategies mediated the relationship between cumulative traumatic experiences and CPTSD. Specifically, experiential avoidance and catastrophizing acted as the mediation effect on the relation between the cumulative traumatic experiences and complex posttraumatic stress disorders (CPTSD), respectively. Furthermore, the chain mediating effect of experiential avoidance on self-blame/rumination/catastrophizing was also found. Therefore, reducing the incidence of traumatic events, activating children's behavior, and adjusting the pattern of negative cognition may contribute to the prevention and alleviation of children's CPTSD.

Key words: elementary students, cumulative traumatic experiences, experiential avoidance, negative cognitive, traumatic events

CLC Number: 

  • B844
Abramson, L. Y., Seligman, M. E., & Teasdale, J. D. (1978). Learned helplessness in humans:Critique and reformulation. Journal of Abnormal Psychology, 87(1), 49-74.
Aldao, A., & Nolen-Hoeksema, S. (2010). Specificity of cognitive emotion regulation strategies:A transdiagnostic examination.Behaviour Research Therapy, 48(10), 974-983.
Anderson, J. C., & Gerbing, D. W. (1988). Structual equation modeling in practice:A review and recommended two-step approach.Psychological Bulletin, 103(3), 411-423.
Beck, A. T., Lerner, R. M., Phillipson, A., Tilley, S., Kim, S. B., Lotringer, S., & Vouyoukas, E. L. (Eds). (1976). Cognitive therapy and the emotional disorders. New American Library.
Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder.Psychological Review, 103(4), 670-686.
Chamberlain, J. M., & Haaga, D. A. F. (2001). Unconditional self-acceptance and psychological health.Journal of Rational Emotive & Cognitive Behavior Therapy, 19(3), 163-175.
Chawla, N., & Ostafin, B. (2007). Experiential avoidance as a functional dimensional approach to psychopathology:An empirical review.Journal of Clinical Psychology, 63(9), 871-890.
Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder:A latent class analysis.European Journal of Psychotraumatology, 5(4), 299-300.
Cloitre, M., Hyland, P., Bisson, J. I., Brewin, C. R., Roberts, N. P., Karatzias, T., & Shevlin, M. (2019). ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder in the United States:A population-based study.Journal of Traumatic Stress, 32(6), 833-842.
Copeland, W. E., Shanahan, L., Hinesley, J., Chan, R. F., Aberg, K. A., Fairbank, J. A., … Costello, E. J. (2018). Association of childhood trauma exposure with adult psychiatric disorders and functional outcomes.JAMA Network Open, 1(7), Article e184493. https://doi.org/10.1001/jamanetworkopen.2018.4493
Cox, R. C., & Olatunji, B. O. (2017). Linking attentional control and PTSD symptom severity:The role of rumination.Cognitive Behaviour Therapy, 46(5), 421-431.
Cribb, G., Moulds, M. L., & Carter, S. (2012). Rumination and experiential avoidance in depression.Behaviour Change, 23(3), 165-176.
Dvir, Y., Ford, J. D., Hill, M., & Frazier, J. A. (2014). Childhood maltreatment, emotional dysregulation, and psychiatric comorbidities.Harvard Review of Psychiatry, 22(3), 149-161.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder.Behaviour Research and Therapy, 38(4), 319-345.
Garnefski, N., & Kraaij, V. (2006). Cognitive emotion regulation questionnaire-development of a short 18-item version (CERQ-short).Personality and Individual Differences, 41(6), 1045-1053.
Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes:Implications for affect, relationships, and well-being.Journal of Personality and Social Psychology, 85(2), 348-362.
Haselgruber, A., Solva, K., & Lueger-Schuster, B. (2020). Validation of ICD-11 PTSD and complex PTSD in foster children using the International Trauma Questionnaire.Acta Psychiatrica Scandinavica, 141(1), 60-73.
Haves, S. C., Wilson, K. G., Gifford, E. V., & Follette, V. M. (1996). Experiential Avoidance and Behavioral Disorder:A Functional Dimensional Approach to Diagnosis and Treatment.Journal of Consulting and Clinical Psychology, 64(6), 1152-1168.
Ho, G. W. K., Hyland, P., Shevlin, M., Chien, W. T., Inoue, S., Yang, P. J., … Karatzias, T. (2020). The validity of ICD-11 PTSD and Complex PTSD in East Asian cultures:Findings with young adults from China, Hong Kong, Japan, and Taiwan.European Journal of Psychotraumatology, 11(1), Article 1717826. https://doi.org/10.1080/20008198.2020.1717826
Hosseini Ramaghani, N. A., Rezaei, F., Sepahvandi, M. A., Gholamrezaei, S., & Mirderikvand, F. (2019). The mediating role of the metacognition, time perspectives and experiential avoidance on the relationship between childhood trauma and post-traumatic stress disorder symptoms.European Journal of Psychotraumatology, 10(1), Article 1648173. https://doi.org/10.1080/20008198.2019.1648173
Hyland, P., Murphy, J., Shevlin, M., Vallieres, F., McElroy, E., Elklit, A., … Cloitre, M. (2017). Variation in post-traumatic response:the role of trauma type in predicting ICD-11 PTSD and CPTSD symptoms.Social Psychiatry and Psychiatric Epidemiology, 52(6), 727-736.
Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events:Applications of the schema construct.Social Cognition, 7(2), 113-136.
Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders:An update on the empirical evidence.Dialogues Clinical Neuroscience, 17(3), 337-346.
Karatzias, T., Shevlin, M., Fyvie, C., Hyland, P., Efthymiadou, E., Wilson, D., … Cloitre, M. (2017). Evidence of distinct profiles of Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) based on the new ICD-11 Trauma Questionnaire (ICD-TQ).Journal of Affective Disorders, 207, 181-187.
Karatzias, T., Shevlin, M., Hyland, P., Brewin, C. R., Cloitre, M., Bradley, A., … Roberts, N. P. (2018). The role of negative cognitions, emotion regulation strategies, and attachment style in complex post-traumatic stress disorder:Implications for new and existing therapies.British Journal of Clinical Psychology, 57(2), 177-185.
Kashdan, T. B., Barrios, V., Forsyth, J. P., & Steger, M. F. (2006). Experiential avoidance as a generalized psychological vulnerability:Comparisons with coping and emotion regulation strategies.Behaviour Research and Therapy, 44(9), 1301-1320.
Kinderman, P., & Bentall, R. P. (1997). Causal attributions in paranoia and depression:Internal, personal, and situational attributions for negative events.Journal of Abnormal Psychology, 106(2), 341-345.
Li, J., Zhang, W., Chen, W., Yuan, H., Zhang, S., Tian, M., & Qu, Z. (2019). Applications of the Chinese version of the primary care PTSD screen for DSM-5 (PC-PTSD-5) for children.Journal of Affective Disorders, 254, 109-114.
Liddell, B. J., Nickerson, A., Felmingham, K. L., Malhi, G. S., Cheung, J., Den, M., … Bryant, R. A. (2019). Complex posttraumatic stress disorder symptom profiles in traumatized refugees.Journal of Traumatic Stress, 32(6), 822-832.
Lloyd, D. A., & Taylor, J. (2006). Lifetime cumulative adversity, mental health and the risk of becoming a smoker.Health, 10(1), 95-112.
Manos, R. C., Kanter, J. W., & Luo, W. (2011). The behavioral activation for depression scale-short form:Development and validation.Behavior Therapy, 42(4), 726-739.
Mcfarlane, A. C. (1986). Posttraumatic phenomena in a longitudinal study of children following a natural disaster.Journal of the American Academy of Child & Adolescent Psychiatry, 26, 764-769.
Meaney, R., Hasking, P., & Reupert, A. (2016). Borderline personality disorder symptoms in college students:The complex interplay between alexithymia, emotional dysregulation and rumination.PLoS One, 11(6), Article e0157294. https://doi.org/10.1371/journal.pone.0157294
Møller, L., Augsburger, M., Elklit, A., Søgaard, U., & Simonsen, E. (2020). Traumatic experiences, ICD-11 PTSD, ICD-11 complex PTSD, and the overlap with ICD-10 diagnoses.Acta Psychiatrica Scandinavica, 141(5), 421-431.
Noyman-Veksler, G., Shalev, H., Brill, S., Rudich, Z., & Shahar, G. (2018). Chronic pain under missile attacks:Role of pain catastrophizing, media, and stress-related exposure.Psychological Trauma:Theory, Research, Practice,and Policy, 10(4), 463-469.
Pickett, S. M., Bardeen, J. R., & Orcutt, H. K. (2011). Experiential avoidance as a moderator of the relationship between behavioral inhibition system sensitivity and posttraumatic stress symptoms.Journal of Anxiety Disorders, 25(8), 1038-1045.
Prins, A., Bovin, M. J., Smolenski, D. J., Marx, B. P., Kimerling, R., Jenkins-Guarnieri, M. A., … Leyva, Y. E. (2016). The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5):Development and evaluation within a veteran primary care sample.Journal of General Internal Medicine, 31(10), 1206-1211.
Risser, H. J., Hetzel-Riggin, M. D., Thomsen, C. J., & McCanne, T. R. (2006). PTSD as a mediator of sexual revictimization:The role of reexperiencing, avoidance, and arousal symptoms.Journal of Traumatic Stress, 19(5), 687-698.
Shipman, K., Edwards, A., Brown, A., Swisher, L., & Jennings, E. (2005). Managing emotion in a maltreating context:A pilot study examining child neglect.Child Abuse & Neglect, 29(9), 1015-1029.
Slanbekova, G. K., Chung, M. C., Ayupova, G. T., Kabakova, M. P., Kalymbetova, E. K., & Korotkova-Ryckewaert, N. V. (2019). The relationship between posttraumatic stress disorder, interpersonal sensitivity and specific distress symptoms:The role of cognitive emotion regulation.Psychiatric Quarterly, 90(4), 803-814.
S lva, K., Haselgruber, A., & Lueger-Schuster, B. (2020). The relationship between cumulative traumatic experiences and ICD-11 post-traumatic symptoms in children and adolescents in foster care:The mediating effect of sense of coherence.Child Abuse & Neglect, 101, Article 104388. https://doi.org/10.1016/j.chiabu.2020.104388
刘慧琴, 吴希林, 邓云龙. (2018). 大学生特质正念与抑郁情绪:经验回避和冗思的链式中介作用. 中国临床心理学杂志, 26(3), 565-569.
周浩, 龙立荣. (2004). 共同方法偏差的统计检验与控制方法. 心理科学进展, 14(6), 895-900.
温忠麟, 侯杰泰, 马什赫伯特. (2004). 结构方程模型检验:拟合指数与卡方准则. 心理学报, 36(2), 186-194.
温忠麟, 张雷, 侯杰泰, 刘红云. (2004). 中介效应检验程序及其应用. 心理学报, 36(5), 614-620.
田雨馨, 伍新春, 陈杰灵, 王文超. (2019). 复杂性创伤后应激障碍:概念、评估、成因及干预. 北京师范大学学报:社会科学版, (5), 24-36.
罗浩贤, 符仲芳, 李迪, 邢怡伦, 王建平. (2018). 灾难化解释对健康焦虑的影响:有调节的中介作用. 中国临床心理学杂志, 26(2), 289-293.
蔡琳, 钟明洁, 朱熊兆, 唐秋萍, 王芹, 王海星, 张逸. (2012). 抑郁性障碍患者的症状表现与认知情绪调节方式的关系. 中国临床心理学杂志, 20(2), 176-178.
[1] HE Can, WEI Hua, XIE Xiaochun, LEI Yuju. Effect of Parents' Phubbing on Adolescents' Self-injury: A Perspective of Experiential Avoidance Model [J]. Psychological Development and Education, 2022, 38(2): 287-294.
[2] GE Guohong. The Relationship between Adult Attachment and Theory of Mind: The Mediators of Cognitive Fusion and Experiential Avoidance [J]. Psychological Development and Education, 2022, 38(2): 223-235.
[3] DOU Fen, LI Qiaoling, WANG Shuhao. Self-differentiation and College Students'Experiential Avoidance: Mediating Effect of Shyness and Its Gender Difference [J]. Psychological Development and Education, 2021, 37(4): 517-524.
[4] JIA Yanru, ZHANG Shouchen, JIN Tonglin, ZHANG Lu, ZHAO Siqi, LI Qi. Effect of Attachment Anxiety on Hoarding Behaviour of College Students: Mediating Role of Intolerance of Uncertainty and Experiential Avoidance [J]. Psychological Development and Education, 2019, 35(4): 393-400.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!