The Impact of Experiential Avoidance and Event Centrality in Trauma-Related Rumination and Posttraumatic Stress.
Experiential avoidance, not rumination itself, turns trauma thoughts into PTSD.
01Research in Context
What this study did
Stevens et al. (2018) asked adults with trauma histories to fill out four surveys. The surveys measured rumination, PTSD symptoms, and two types of avoidance.
The team used statistics to see if avoidance sits between rumination and PTSD. In other words, does rumination hurt only when people also try to avoid their own thoughts and feelings?
What they found
Yes. Experiential avoidance acted like a bridge. More rumination led to more avoidance, which then led to worse PTSD.
When the statisticians removed the avoidance bridge, rumination alone no longer predicted PTSD severity.
How this fits with other research
Dymond et al. (2018) explain why avoidance can spread so fast. Humans can relate any two events in their minds, so a person can learn to avoid a thought they have never met in real life.
Dymond et al. (2007) showed this in the lab. After teaching same/opposite relations, college students avoided pictures that were only indirectly related to a mild shock.
Matson et al. (2008) go further. They say rumination itself can be a form of avoidance. People angrily replay memories to escape the feeling of anger. S et al. now show the same pattern in trauma: avoidance is the engine, rumination is the fuel.
Why it matters
If avoidance is the active ingredient, you can target it directly. Ask clients to notice trauma thoughts without pushing them away. Use brief exposure, mindfulness, or values work. When avoidance drops, rumination loses its punch and PTSD scores fall. Try adding a five-minute acceptance exercise at the start of your next session and track mood ratings before and after.
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02At a glance
03Original abstract
Cognitive control strategies like rumination often increase posttraumatic stress disorder (PTSD) symptoms. However, extant research has provided equivocal results when attempting to explain why this phenomenon occurs. The current study explored several mechanisms that may clarify such findings. For this study, 193 trauma-exposed community members completed measures of PTSD, rumination, experiential avoidance, and event centrality. Elevated reports of rumination were associated with greater PTSD symptomology, experiential avoidance, and event centrality. Results suggest that rumination indirectly influenced PTSD symptom severity through experiential avoidance. This pattern held true regardless of whether a trauma survivor viewed their reported trauma as central or peripheral to their personal identity. These data suggest that the link between ruminating about a traumatic experience and enhanced PTSD symptomology may be partially explained by increasingly restrictive cognitive patterns and enhanced avoidance of aversive internal stimuli. Furthermore, they provide preliminary evidence to suggest that rumination and experiential avoidance are strongly associated with one another (and subsequent PTSD symptomology) among trauma survivors, regardless of how central a traumatic event is to an individual's personal narrative. Such findings support clinical interventions like exposure, which progressively support new learning in response to feared or unwanted experiences in service of expanding an individual's cognitive and behavioral repertoires.
Behavior modification, 2018 · doi:10.1177/0145445517747287