[Home ] [Archive]   [ فارسی ]  
:: Main :: About :: Current Issue :: Archive :: Search :: Submit :: Contact ::
:: Volume 23, Issue 5 (Bimonthly 2019) ::
Feyz 2019, 23(5): 543-553 Back to browse issues page
The mediating role of the metacognitions and experiential avoidance on the relationship between childhood trauma and PTSD symptoms
Nasrin Alsadat Hosseini , Fatemeh Rezaei * , Mohammad Ali Sepahvandi , Simin Gholamrezaei , Fazlolla Mirdrikvand
Department of Psychology, Faculty of Literature and Humanities, Lorestan University, Khorramabad, I.R. Iran. , rezaei.f@lu.ac.ir
Abstract:   (3420 Views)
Background: Given the likelihood of recurrence of symptoms of posttraumatic stress disorder (PTSD) and the inadequacy of therapeutic approaches in the lasting recovery of symptoms of this disorder, the precise identification of the factors involved in initiating and maintaining PTSD is very important. In this regard, the present study aimed to investigate the intermediate role of metacognition and experiential avoidance in the relationship between childhood trauma and PTSD symptoms.
Materials and Methods: The subjects of this analytical-cross-sectional research were 432 patients (278 females and 154 males) who were seeking treatment at the health centers of Shiraz in spring, summer, autumn and winter of 2018, which were selected according to the inclusion and exclusion criteria and the Structured Interview for Axis I and II disorders (SCID). The PTSD Checklist —5 (PCL-5), Childhood Trauma Questionnaire (CTQ), Metacognitions Questionnaire (MCQ-30) and Acceptance and Action Questionnaire–II (AAQ-II) were used. Data were analyzed with the structural equation modeling (SEM) in Amos software (23-ver).
Results: The results showed that the proposed model was well fitted (CFI=0.97, GFI=0.93, TLI=0.96, IFI=0.97, NFI=0.97, RMSEA=0.07), and all of the direct and indirect path coefficients were significant at the alpha level of 0.01. So that metacognition and experiential avoidance significantly mediated the relationship between childhood trauma and PTSD symptoms.
Conclusion: The findings of this study suggest that considering the role of childhood trauma, metacognition and experimental avoidance in the design of psychological interventions for the people with PTSD is helpful/essential.
Keywords: Posttraumatic Stress Disorder, Childhood Trauma, Metacognition, Experimental Avoidance
Full-Text [PDF 445 kb]   (2263 Downloads)    
Type of Study: Research | Subject: General
Received: 2019/02/22 | Revised: 2019/12/23 | Accepted: 2019/07/24 | Published: 2019/12/16
1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub; 2013.
2. Kessler RC, Berglund PA, Bruce ML, Koch JR, Laska EM, Leaf PJ, et al. The prevalence and correlates of untreated serious mental illness. HSR 2001; 36(6 Pt 1): 987-1007.
3. Pillar G, Harder L, Malhotra A. Trauma and Post‐Traumatic Stress Disorder. Sleep: A comprehensive handbook 2005; 4: 857-66.
4. Kilpatrick DG, Resnick HS, Milanak ME, Miller MW, Keyes KM, Friedman MJ. National estimates of exposure to traumatic events and PTSD prevalence using DSM‐IV and DSM‐5 criteria. JTS 2013; 26(5): 537-47.
5. Cesur R, Sabia JJ, Tekin E. The psychological costs of war: military combat and mental health. J Health Econ 2013; 32(1): 51-65.
6. Leahy RL, Tirch D, Napolitano LA. Emotion regulation in psychotherapy: A practitioner's guide. Guilford Press; 2011.
7. Bisson J, Andrew M. Psychological treatment of post-traumatic stress disorder (PTSD). New York, NY: Wiley; 2007.
8. Westphal M, Leahy RL, Pala AN, Wupperman P. Self-compassion and emotional invalidation mediate the effects of parental indifference on psychopathology. Psychiatry Res 2016; 242: 186-91.
9. Mazloom M, Yaghubi H, Mohammadkhani S. Post-traumatic stress symptom, metacognition, emotional schema and emotion regulation: A structural equation model. Pers Indiv Differ 2016; 88: 94-8.
10. Seligowski AV, Rogers AP, Orcutt HK. Relations among emotion regulation and DSM-5 symptom clusters of PTSD. Pers Indiv Differ 2016; 92:104-8.
11. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl 2003; 27(2): 169-90.
12. Schalinski I, Teicher MH, Nischk D, Hinderer E, Müller O, Rockstroh B. Type and timing of adverse childhood experiences differentially affect severity of PTSD, dissociative and depressive symptoms in adult inpatients. BMC Psychiatry 2016; 16(1): 295.
13. Ramo‐Fernández L, Schneider A, Wilker S, Kolassa IT. Epigenetic alterations associated with war trauma and childhood maltreatment. Behav Sci Law 2015; 33(5): 701-21.
14. Myers SG, Wells A. Early trauma, negative affect, and anxious attachment: the role of metacognition. Anxiety Stress Copin 2015; 28(6): 634-49.
15. Scarpa A, Wilson LC, Wells AO, Patriquin MA, Tanaka A. Thought control strategies as mediators of trauma symptoms in young women with histories of child sexual abuse. Behav Res Therapy 2009; 47(9): 809-13.
16. Raes F, Hermans D. On the mediating role of subtypes of rumination in the relationship between childhood emotional abuse and depressed mood: Brooding versus reflection. Depress Anxiety 2008; 25(12): 1067-70.
17. Schneider W. The development of metacognitive knowledge in children and adolescents: Major trends and implications for education. MBE 2008; 2(3): 114-21.
18. Brinck I, Liljenfors R. The developmental origin of metacognition. Infant Child Dev 2013; 22(1): 85-101.
19. Barlow MR, Goldsmith RE. Childhood trauma and active mental processes: Dissociation and metacognition influence control of negative thoughts. Child Adolesc Trauma 2014; 7(2): 131-40.
20. Seligowski AV, Lee DJ, Bardeen JR, Orcutt HK. Emotion regulation and posttraumatic stress symptoms: A meta-analysis. Cogn Behav Ther 2015; 44(2): 87-102.
21. Kashdan TB, Barrios V, Forsyth JP, Steger MF. Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behav Res Ther 2006; 44(9): 1301-20.
22. Shenk CE, Putnam FW, Noll JG. Experiential avoidance and the relationship between child maltreatment and PTSD symptoms: Preliminary evidence. Child Abuse Neglect 2012; 36(2): 118-26.
23. Kashdan TB, Barrios V, Forsyth JP, Steger MF. Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behav Res Ther 2006; 44(9): 1301-20.
24. Kline RB. Principles and practice of structural equation modeling. Guilford publications; 2015.
25. Mohammad Khani P. Structured Clinical Interview for DSM-IV-TR Disorders. Tehran: Dangeh Publications; 2010.
26. Amini H, Sharifi V, Asadi SM, Mohammadi MR, Kaviani H, Semnani Y. Validity of the Persian version of the Diagnostic Structured Interview for Axis I Disorders in SCID-I (DSMIV). Payesh 2007; 7(1): 49-57. [in Persian]
27. Maffei C, Fossati A, Agostoni I, Barraco A, Bagnato M, Deborah D, et al. Interrater reliability and internal consistency of the structured clinical interview for DSM-IV axis II personality disorders (SCID-II), version 2.0. J Pers Disord 1997; 11(3): 279-84.
28. Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The posttraumatic stress disorder checklist for DSM‐5 (PCL‐5): Development and initial psychometric evaluation. J Trauma Stress 2015; 28(6): 489-98.
29. Ebrahimi H, Dejkam M, Seghatoleslam T. Childhood Traumas and Suicide Attempt in adulthood. IJPCP 2014; 19(4): 275-82.
30. Wells A, Cartwright-Hatton S. A short form of the metacognitions questionnaire: properties of the MCQ-30. Behav Res Ther 2004; 42(4): 385-96.
31. Shirinzadeh Dastgiri S, Goodarzi MA, Rahimi Ch, Nazari Q. Investigating factor structure, validity and validity of meta-cognitive questionnaire-30. J Psychol 2008; 4(48): 445-61.
32. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, Waltz T, Zettle RD. Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behav Ther 2011; 42(4): 676-88.
33. Abasi E, Fata L, Molodi R, Zarabi H. Psychometric Adequacy of Acceptance and Act.ion Questionnaire-II. J Psychol Methods Models 2012; 10, 65-80.
34. Floyd FJ, Widaman KF. Factor analysis in the development and refinement of clinical assessment instruments. Psychol Assess 1995; 7(3): 286.
35. Kline RB. Principles and practice of structural equation modeling. Guilford publications; 2015.
36. Browne MW, Cudeck R. Alternative ways of assessing model fit. Sage focus editions 1993; 154: 136-.
37. Hooper D, Coughlan J, Mullen M. Structural equation modelling: Guidelines for determining model fit. Electronic. EJBRM 2008; 6(1): 53-60.
38. Vang ML, Shevlin M, Karatzias T, Fyvie C, Hyland P. Dissociation fully mediates the relationship between childhood sexual and emotional abuse and DSM-5 PTSD in a sample of treatment-seeking adults. EJTD 2018; 2(4): 173-8.
39. Warnke AS, Nagy SM, Pickett SM, Jarrett NL, Hunsanger JA. The examination of behavior inhibition system sensitivity, experiential avoidance, and sex in relation to post-traumatic stress symptom severity: Comparison of a moderated versus mediated model. Pers Indiv Differ 2018; 132: 60-5.
40. Lowell A, Renk K, Adgate AH. The role of attachment in the relationship between child maltreatment and later emotional and behavioral functioning. Child Abuse Negl 2014; 38(9): 1436-49.
41. Takarangi MK, Smith RA, Strange D, Flowe HD. Metacognitive and metamemory beliefs in the development and maintenance of posttraumatic stress disorder. Clin Psychol Sci 2017; 5(1): 131-40.
42. Kline NK, Berke DS, Rhodes CA, Steenkamp MM, Litz BT. Self-blame and PTSD following sexual assault: a longitudinal analysis. J Interpers Violence 2018; 1: 0886260518770652.
43. Hayes SA, Orsillo SM, Roemer L. Changes in proposed mechanisms of action during an acceptance-based behavior therapy for generalized anxiety disorder. Behav Res Ther 2010; 48(3): 238-45.
Send email to the article author

Add your comments about this article
Your username or Email:


XML   Persian Abstract   Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Hosseini N A, Rezaei F, Sepahvandi M A, Gholamrezaei S, Mirdrikvand F. The mediating role of the metacognitions and experiential avoidance on the relationship between childhood trauma and PTSD symptoms. Feyz 2019; 23 (5) :543-553
URL: http://feyz.kaums.ac.ir/article-1-3824-en.html

Creative Commons License
This open access journal is licensed under a Creative Commons Attribution-NonCommercial ۴.۰ International License. CC BY-NC ۴. Design and publishing by Kashan University of Medical Sciences.
Copyright ۲۰۲۳© Feyz Medical Sciences Journal. All rights reserved.
Volume 23, Issue 5 (Bimonthly 2019) Back to browse issues page
مجله علوم پزشکی فیض Feyz Medical Sciences Journal
Persian site map - English site map - Created in 0.05 seconds with 30 queries by YEKTAWEB 4570