Self-Compassion and Psychological Flexibility in a Treatment-Seeking Sample of Women Survivors of Interpersonal Violence.

Interpersonal violence is pervasive and is related to numerous negative psychological outcomes. This study examines self-compassion and psychological flexibility as potential protective factors for the range of diverse problems associated with interpersonal trauma. A community sample of 27 women (mean age = 37.74, SD = 16.16) participated in a larger pilot intervention study for psychological distress related to interpersonal violence. In this treatment-seeking sample, self-compassion was positively associated with psychological flexibility and negatively linked to higher levels of trauma-related distress, including posttraumatic stress disorder (PTSD) symptoms as well as problems related to the self and relations with others. The results suggest that self-compassion and psychological flexibility may function as protective factors in the development of problems in survivors of interpersonal violence.

Acceptance and commitment therapy as a nonpathologizing intervention approach for survivors of trauma.

Acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 2012) is proposed as a nonpathologizing approach to trauma-related problems. ACT has at its core a functional approach to understanding the human condition such that problems are maintained by functional processes, such as avoidance. Treatment focuses on these processes to institute change, stepping away from directly pursuing symptoms as an evaluative outcome. A collaborative, client-centered approach is used in defining valued life directions and committing to action based on those values. ACT presents a method of approaching trauma-related problems that is structured to support a client in finding a life beyond trauma that has value.

An investigation of experiential avoidance, emotion dysregulation, and distress tolerance in young adult outpatients with borderline personality disorder symptoms.

In this study we investigated 3 domains of emotional functioning--emotion dysregulation, distress tolerance, and experiential avoidance--in young adult outpatients with borderline personality disorder (BPD) symptoms. Participants were 40 young adult outpatients at a university counseling center who reported current suicidal ideation and met diagnostic criteria for BPD or experienced subthreshold BPD symptoms (i.e., met diagnostic criteria for 3 or 4 symptoms). Participants completed 3 self-report measures of emotional functioning-experiential avoidance (Acceptance and Action Questionnaire-2; Bond et al., 2011; Hayes et al., 2004), emotion dysregulation (Difficulties in Emotion Regulation Scale; Gratz & Roemer, 2004), and distress tolerance (Distress Tolerance Scale; Simons & Gaher, 2005)-and a behavioral measure of distress tolerance (Paced Auditory Serial Addition Task-Computerized; Lejuez, Kahler, & Brown, 2003), in addition to self-report measures of depression and BPD symptom severity. Partial correlations demonstrated that both emotion dysregulation and experiential avoidance were significantly associated with BPD symptom severity after accounting for depression. However, neither the self-report nor behavioral measure of distress tolerance were related to BPD symptom severity. A regression analysis with emotion dysregulation and experiential avoidance as independent variables revealed that only experiential avoidance was significantly associated with BPD symptom severity after controlling for depression symptoms. The current findings suggest that experiential avoidance may be a central process in BPD symptom severity. Future research directions are discussed.

Adult disclosure of a history of childhood sexual abuse: implications for behavioral psychotherapy.

This article presents a behavioral conceptualization of the difficulties associated with adult disclosure in psychotherapy of a history of childhood sexual abuse. Using a contemporary behavioral perspective and a functional analysis of various clinical presentations, we examine the factors that may contribute to nondisclosure of a history of abuse. Traumagenic dynamics are used to frame a discussion of childhood factors that may further influence disclosure of abuse. The construct of stigma is linked to aspects of experiential avoidance, which is considered to be a core mediator of the difficulties associated with a history of abuse. Acceptance and commitment therapy and functional analytic psychotherapy, 2 "third-wave" behavioral treatments, are presented generally with specific discussions of these therapies as they relate to the issue of disclosure. Important therapist factors as well as implications for future investigations are presented.

Sexual victimization and physical health: an examination of explanatory mechanisms.

There is a growing body of research illustrating a significant relationship between a history of sexual victimization and the development of physical health problems; however, few researchers have examined variables that mediate this relationship. The present study examined two potential mediating variables: experiential avoidance and current stress. Results indicated that current stress significantly mediated the relationship between adult sexual assault and physical health complaints, and experiential avoidance may be a partial mediator. Implications of the findings and future directions are discussed.

Sexual functioning and sexual satisfaction among women who report a history of childhood and/or adolescent sexual abuse.

This study examined the relationship between sexual functioning, sexual satisfaction, and predictor variables (experiential avoidance, relationship violence, relationship satisfaction, anger, and psychological distress) in 22 women reporting a history of childhood and/or adolescent sexual abuse. Sexual satisfaction correlated significantly with all predictor variables. Sexual functioning correlated significantly with relationship violence only. Interestingly, sexual satisfaction and sexual functioning were not significantly correlated. Two hierarchical regression equations, using sexual satisfaction and sexual functioning as dependent variables and using the same predictor variables, were tested. Results suggest that different factors may account for sexual satisfaction and sexual functioning and more research is needed to clarify this relationship.

The effects of sexual assault-related intrusion suppression in the laboratory and natural environment.

Individuals with a history of sexual victimization often experience enduring intrusive thoughts associated with their assault history. Research suggests that the characteristic ways in which sexually assaulted individuals respond to aversive internal experiences (i.e., thoughts, emotions, etc.) can influence the psychological distress associated with these intrusions. This study investigated the effects of suppressing sexual assault-related intrusions in a sample of 61 female college students with a history of adolescent or adult sexual assault and recent assault-related intrusions. Participants were randomly assigned to suppress or monitor intrusions during a laboratory task and for 48 h outside the laboratory. In contrast to study hypotheses, findings indicated that intrusion monitoring was associated with higher subjective distress than suppression both in the laboratory and in the natural environment. No differences were found for the frequency of intrusions between groups in the laboratory. However, modest evidence for a rebound effect in intrusion frequency was found outside the laboratory.

Vicarious traumatization: potential hazards and interventions for disaster and trauma workers.

Disaster and trauma workers often disregard their own reactions and needs when focusing on caring for those directly exposed to traumatic events. This article discusses the concept of vicarious traumatization, a form of post-traumatic stress response sometimes experienced by those who indirectly are exposed to traumatic events. It includes an examination of how vicarious trauma reactions are experienced across different professions, and suggestions on how to limit or prevent vicarious traumatization. The authors review self-care strategies as well as training and organizational considerations that may be beneficial for individuals and organizations to address.

Experimental avoidance as a mediator of the effects of adolescent sexual victimization on negative adult outcomes.

The study examined experiential avoidance as a mediator between sexual victimization and negative adult outcomes. Baron and Kenny's (1986) regression analyses were performed on a sample of 304 undergraduate women to assess direct and indirect effects of sexual victimization on depressive, psychological distress, and alcohol abuse symptoms. Experiential avoidance accounted for statistically significant, but modest effects of victimization on depressive and distress symptoms. Child sexual abuse was not directly associated with experiential avoidance or negative outcomes, but increased vulnerability for adolescent sexual victimization. Adolescent sexual victimization contributed to increased experiential avoidance, which was associated with greater negative outcomes. These results uniquely contribute to the existing literature linking experiential avoidance to psychological problems.

Sexual functioning in women reporting a history of child sexual abuse: review of the empirical literature and clinical implications.

Researchers have frequently linked childhood sexual abuse (CSA) with some form of adult sexual disturbance. Unfortunately, research on how to treat sexual dysfunctions in women with a history of childhood sexual abuse has lagged behind. In this article, we review the literature concerning childhood sexual abuse and sexual dysfunction. In addition, we look at two theories that help explain the relationship between CSA and sexual dysfunction. Both of these theories highlight the importance of emotional experience. The contextual behavioral model described by Polusny and Follette (1995) is derived from the work of Hayes and colleagues (Hayes, Strosahl, & Wilson, 1999) and focuses on the role of experiential avoidance in understanding the problems experienced by CSA survivors. Greenberg and colleagues' emotion theory (Greenberg & Pavio, 1998; Greenberg, Rice, & Elliott, 1993; Greenberg & Savin, 1987) is useful in highlighting the way in which early abuse experiences can impair emotional development and result in maladaptive emotional schemes contributing to sexual problems. Treatments for CSA survivors' sexual problems based on the two above theories are outlined. The question concerning the applicability of traditional sex therapy for CSA survivors versus a modified treatment is discussed and recent developments in the field of sexual functioning as well as future directions for the field are also highlighted.