A prospective examination of the role of psychological (in)flexibility in posttraumatic stress: A cross-lagged panel design.

Functional contextualist models of psychopathology suggest that psychological inflexibility and psychological flexibility are of central importance for understanding the development and maintenance of posttraumatic stress (PTS) symptomatology. To our knowledge, these two constructs and their domain-specific factors (e.g., cognitive fusion, experiential avoidance) have not been assessed in their entirety and examined in relation to PTS symptoms using a longitudinal study design. As such, the primary aim of the present study was to use cross-lagged panel analysis, an analytic approach that allows stronger causal inferences to be made regarding the nature of temporal relations among study variables, to determine the directional relations among PTS symptoms and psychological flexibility and inflexibility over an eight-month time period. Trauma-exposed adults (N = 810), recruited online via Amazon's Mechanical Turk (MTurk), completed a battery of self-report measures via a secure online platform at three time points, spanning eight months. Results suggest that the relationship between psychological inflexibility and PTS symptoms is bidirectional and mutually reinforcing. In contrast, significant prospective relations were not observed between psychological flexibility and PTS symptoms. Results of a follow-up exploratory path analysis showed that cognitive fusion was the only psychological inflexibility subfactor that partially mediated the relationship between PTS symptoms from baseline to the eight-month follow-up assessment. Taken together, these results suggest that psychological inflexibility, and primarily the domain of cognitive fusion, maintains PTS symptoms following trauma exposure. As such, it may important to integrate cognitive defusion techniques into evidence-based treatments for Posttraumatic Stress Disorder (PTSD).

Investigating the specific domains of the cognitive attentional syndrome that predict posttraumatic stress symptoms: The moderating effect of attentional control.

The metacognitive model of posttraumatic stress disorder (PTSD) suggests that persistent use of the maladaptive self-regulation strategies that comprise the cognitive attentional syndrome (CAS) increases the likelihood of developing PTSD symptoms following trauma exposure. The metacognitive model also suggests that flexible regulation of attention might be protective against developing maladaptive outcomes that are associated with the CAS. The aims of this study were to (1) examine associations between all seven domains of the CAS and PTSD symptoms using a recently developed, multidimensional measure of the CAS, and (2) examine the moderating effect of self-reported attentional control on associations between the CAS and PTSD symptoms. Participants were trauma-exposed community adults (N = 237) who completed a battery of self-report measures. Results from linear regression analyses showed that worry, substance use, and internal threat monitoring accounted for unique variance in PTSD symptoms when all seven CAS domains were entered into the same model. Moderation analyses showed that attentional control dampened the effect of the CAS, specifically external threat monitoring, on PTSD symptoms. Study results support attentional control as a protective factor against the maladaptive effects of the CAS on PTSD symptoms.

Examining the Factor Structure and Incremental Utility of the Contrast Avoidance Questionnaires via Bifactor Analysis.

The negative emotional contrast avoidance model posits that pathological worry is maintained by the avoidance of negative emotional shifts. The Contrast Avoidance Questionnaires (CAQ-Worry and CAQ-General Emotion) aim to assess contrast avoidance beliefs and behaviors. Questions remain around the factor structures of the CAQs, whether such structures replicate in nonundergraduate samples, and whether their domain-specific factors are valid for independent use. This study used bifactor analysis in a large community sample (N = 827) to address these gaps in the literature. Results supported bifactor models of both measures. Complementary analyses supported the multidimensionality of the CAQ-Worry, including its strong general factor and independent use of two domain-specific factors, rather than the original three domain-specific factors. The CAQ-General Emotion's general factor was strong, but the merits of the Discomfort domain-specific factor require more exploration, and use of the Avoidance domain-specific factor is discouraged.

Cultural adaptation and validation of the Arabic version of the multidimensional cognitive attentional syndrome scale (MCASS).

The cognitive attentional syndrome (CAS) is a core concept within metacognitive theory. The premise of the CAS is related to metacognition, however its role in psychopathology is distinct. Due to the complex nature of the CAS, a theoretically driven and psychometrically sound self-report measure of the CAS for the Arabic population is yet to be developed. We translated the Multidimensional Cognitive Attentional Syndrome Scale (MCASS) into the Arabic language and tested its structural validity. The MCASS was translated according to the standard guidelines of forward-translation followed by backward-translation. In Study 1, the MCASS was administered to a larger sample (N = 1027), selected from 22 Arabic-speaking countries in the Arab League countries, and exploratory factor analysis (EFA) was used to examine the factor structure of the measure. Those who participated in Study 1 were excluded from participating in Study 2. Confirmatory factor analysis (CFA) was used in Study 2 (N = 567) to assess the latent factor structure of MCASS, which supported a six-factor model. Results support multidimensional assessment of the CAS using the MCASS, and demonstrate suitability for use in Arab speaking samples. Implications of this study and recommendations for use of the Arabic version of MCASS are discussed.

Executive functioning deficits exacerbate posttraumatic stress symptoms: A longitudinal mediation model.

Executive functioning (EF) consists of a set of related, but distinct, higher-level cognitive abilities that are used to organize and integrate lower-level processes in the service of engaging in goal-direct behavior. Evidence suggests that deficits in EF are a vulnerability factor for the development of posttraumatic stress (PTS) symptoms. Less understood, however, is the role that EF plays in symptom maintenance and exacerbation following trauma exposure. As such, the primary purpose of the present study was to determine whether EF deficits exacerbate PTS symptoms over the course of one year. A secondary aim of this study was to use a cross-lagged design to determine the directional relations among EF deficits and PTS. Trauma-exposed adults (N = 98) completed a clinical interview and self-report measures at an initial assessment session (Time 1 [T1]). Participants also completed self-report measures at 6- (Time 2 [T2]; n = 92) and 12-month (Time 3 [T3]; n = 91) follow-up sessions. As predicted, EF deficits at T2 mediated the relationship between PTS symptoms from T1 to T3, thus suggesting that EF deficits exacerbate PTS symptoms following trauma exposure. Results from a cross-lagged path analysis from T2 to T3 suggest that deficits in EF exert a stronger influence on the maintenance of PTS symptoms than vice versa. These results have implications for (a) identifying individuals that are at elevated risk for developing PTS symptoms, (b) developing precision medicine-based approaches for alleviating PTS symptoms, and (c) improving well-established PTSD treatments for those with relative deficits in EF.

Eye tracking evidence of threat-related attentional bias in anxiety- and fear-related disorders: A systematic review and meta-analysis.

CONTEXT: Cognitive theories of anxiety- and fear-related pathology suggest that individuals with these forms of pathology (versus those without) exhibit greater threat-related attentional bias (AB). However, there are a multitude of mixed and null findings in this area of research. Unlike other commonly used measures of AB, eye-tracking indices of AB exhibit acceptable reliability, and thus, may help clarify the relationship between AB and anxiety- and fear-related symptoms. OBJECTIVE: The purpose of this study was to conduct a meta-analysis, to determine whether there is evidence of a relationship between anxiety and fear-related symptoms and expressions of threat-related AB (i.e., reflexive orienting and maintenance) measured via free-viewing eye- tracking tasks. DATA SYNTHESIS: A total of 40 articles were retained for this meta-analysis. Significant relations were observed between anxiety and fear-related symptoms and both reflexive orienting toward threat (r = 0.13, 95% CI: 0.03, 0.22) and maintenance of attention on threat (r = 0.15, 95% CI: 0.05, 0.25). CONCLUSIONS: Results from the present study suggests that it may be important to develop attention bias modification interventions that target AB at both early (bottom-up) and later (top-down) stages of information processing to reduce anxiety- and fear-related pathology.

The Interactive Effect of Anxiety Sensitivity and Metacognitive Beliefs on Anxiety.

Anxiety sensitivity (AS) has been identified as a contributing factor to the development and maintenance of anxiety. Individuals with high AS are sensitive to bodily cues and anxiety-related thoughts and often misinterpret these stimuli as catastrophic or dangerous. Similarly, negative and positive metacognitive beliefs (i.e., beliefs about thinking) are believed to increase internal threat monitoring and the use of maladaptive coping strategies, which may increase the impact of AS on anxiety. As such, the purpose of the present study was to examine the moderating role of metacognitive beliefs on the relationship between anxiety sensitivity and anxiety. Adult participants (N = 417), recruited through an online crowdsourcing website, completed a battery of measures assessing the constructs of interest. Results from multiple linear regression indicated that the relationship between AS and anxiety became significantly stronger as negative and positive metacognitive beliefs increased, thus suggesting that negative and positive metacognitive beliefs may exacerbate the effect of AS on anxiety. The development of risk profiles that incorporate AS and negative and positive metacognitive beliefs may be beneficial for early identification of individuals at high risk for the development of anxiety.

Health anxiety and attentional control interact to predict uncertainty-related attentional biases.

BACKGROUND AND OBJECTIVES: Current theories of health anxiety and a growing body of empirical literature suggest that those high in health anxiety symptoms might find uncertainty itself threatening and demonstrate attentional biases for uncertainty-related information (ABU). Moreover, a dual processes model of attention would suggest that individual differences in attentional control might modify such a relationship. The present study was designed to explore this proposed health anxiety-ABU relationship and also to consider attentional control as a moderator of theoretical and clinical relevance. METHODS: Undergraduate participants (N = 148) completed a self-report measure of health anxiety symptoms and two performance-based tasks to assess ABU and attentional control. RESULTS: Hierarchical regression analyses showed a significant interaction between health anxiety and attention control in predicting attentional disengagement from, but not engagement with, uncertainty-related words. Specifically, results of the simple slopes analysis suggested that those with elevated health anxiety symptoms and better attentional control may use top-down attentional control processes to disengage their attention from distressing uncertainty-related stimuli faster than those with worse attentional control. LIMITATIONS: The analogue sample is a study limitation. CONCLUSIONS: Results provide new insights into the nature of attentional biases within health anxiety. Results are discussed in light of recent work on attentional control and avoidance-based psychopathology.

Problematic Smartphone Use Influences the Relationship Between Experiential Avoidance and Anxiety.

Experiential avoidance (EA), an unwillingness to stay in contact with unwanted inner experiences (e.g., emotions, thoughts, and bodily sensations), has been implicated in the development and maintenance of anxiety. Individuals with high levels of EA are more likely to employ maladaptive coping strategies (i.e., avoidance behaviors), which exacerbates emotional distress and anxious arousal. As smartphone ownership has become increasingly common in recent years, problematic smartphone use (PSU) has been suggested to serve as a "safety behavior" in situations in which individuals believe that they might experience emotional discomfort. That is, individuals experiencing emotional distress and/or anxious arousal may overengage in the use of technology to relieve emotional distress. As such, the purpose of this study was to examine PSU as a moderator of the relationship between EA and anxiety. Adult participants (N = 294) recruited through Amazon's Mechanical Turk (MTurk), an online labor market, completed an online battery of self-reported measures. Results indicated that the relationship between EA and anxiety became significantly stronger as PSU increased, thereby suggesting that PSU may exacerbate the effect of EA on anxiety. These findings are a first step toward the development of risk profiles that incorporate EA and PSU. Such risk profiles may be beneficial for early identification and intervention for individuals at high risk for the development of anxiety.

The interactive effect of mental contamination and cognitive fusion on anxiety.

OBJECTIVES: Mental contamination and cognitive fusion have been identified as risk factors for anxiety. The purpose of this study was to examine the moderating effect of cognitive fusion on the relationship between mental contamination and anxiety. METHOD: Participants (N = 504 community adults), recruited via Amazon's Mechanical Turk (MTurk), completed measures of mental contamination, cognitive fusion, and anxiety. RESULTS: Results from a regression analysis showed that the interaction between mental contamination and cognitive fusion predicted anxiety (ß = 0.15, p < 0.001). Simple slopes analysis revealed a positive association between mental contamination and anxiety that was significant at higher (ß = 0.25, p < 0.001), but not lower (ß = 0.01, p = 0.88), levels of cognitive fusion. CONCLUSION: The development of risk profiles that incorporate mental contamination and cognitive fusion may be beneficial for early identification of individuals at high risk for anxiety.

An Examination of the Factor Structure of the Multidimensional Psychological Flexibility Inventory.

The Multidimensional Psychological Flexibility Inventory (MPFI), a 60-item self-report measure, assesses the Acceptance and Commitment Therapy Hexaflex. The factor structure of the MPFI was examined in this study. In a community sample of adults (N = 827), four models (correlated six-factor, one-factor, higher order, and bifactor) were tested for each of the constructs of interest (i.e., psychological flexibility and psychological inflexibility). All models, with the exception of the one-factor, provided adequate fit to the data. Differences between the three adequate fitting models were trivial in magnitude. Additional statistical indices from the bifactor models indicated that the general factors accounted for the large majority of reliable variance. The majority of the domain-specific factors evidenced redundancy with their respective general factors. Results from a series of structural regressions indicated that the domain-specific factors did not provide additional incremental utility above and beyond the general factors in predicting two relevant clinical constructs (i.e., health anxiety and depression). These results provide support for the use of the MPFI Flexibility and Inflexibility total scores, but not subscale scores. The MPFI may require further refinement to either greatly reduce the length of the measure, or to ensure that subscales have incremental utility.

The Moderating Effect of Attentional Control on the Relationship Between COVID Stress and Generalized Anxiety Symptoms.

The recent global pandemic (i.e., COVID-19) has had a serious impact on psychological health, as the stress associated with the pandemic increases the likelihood of developing clinically significant anxiety. Evidence suggests that attentional control may protect those individuals with outcome-specific vulnerabilities from developing maladaptive psychological outcomes. In the present study, attentional control was examined as a moderator of the relation between COVID-19 stress and generalized anxiety symptoms in a community sample (N = 359 adults). As predicted, the relationship between COVID-19 stress and anxiety was moderated by attentional control. Specifically, as attentional control decreased, the strength of the association between COVID-19 stress and anxiety increased. The results suggest that, among those with higher levels of COVID-19 stress, attentional control may act as a protective factor against developing anxiety. It may be beneficial as a matter of standard public health guidance to recommend that the general public engages in activities that are known to improve attentional control and alleviate emotional distress (e.g., mindfulness-based techniques) at the outset of a pandemic or other global catastrophe to reduce the likelihood that prolonged event-related stress will lead to impairing anxiety.

A network analysis of two conceptual approaches to the etiology of PTSD.

Two prominent conceptual models of posttraumatic stress disorder (PTSD) are the cognitive model, associated with cognitive processing therapy (CPT; Resick & Schnicke, 1992), and the functional contextualist model, underlying acceptance and commitment therapy (ACT; Hayes et al., 1999). Network analysis was used to examine dynamic interactions among cognitive (relating to CPT) and functional contextualistic (relating to ACT) variables and PTSD symptoms in a sample of 722 trauma-exposed adults. Results from the cognitive networks highlighted the importance of maladaptive beliefs about threat in maintaining the co-occurrence of PTSD symptoms and cognitive variables. Additionally, PTSD symptoms were more likely to lead to cognitive variables, rather than the reverse direction. Results from the functional contextualist networks identified numerous associations amongst variables that contribute to the co-occurrence of PTSD symptoms and psychological inflexibility. Findings from this study may help generate causal hypotheses that can be tested further using a longitudinal study design.

Increasing cognitive load attenuates the moderating effect of attentional inhibition on the relationship between posttraumatic stress symptoms and threat-related attention bias variability.

Theory and empirical evidence suggest that those with higher posttraumatic stress (PTS) symptoms and better attentional control (i.e., the strategic control of higher-order executive attention in regulating bottom-up, stimulus driven responses to prepotent stimuli; Sarapas et al., 2017) can use that ability to disengage and shift attention away from threat stimuli and reduce threat-related attentional dysregulation (i.e., avoidance/overcontrollers). Those with relatively worse attentional control lack the requisite resources to do this, leading to prolonged attentional engagement with threat stimuli and threat-related attention dysregulation (i.e., maintenance/undercontrollers). Given that attentional control is a limited resource, strategic avoidance of threat information or reduced threat-related attention dysregulation may not be possible among those with relatively higher attentional control when cognitive load is relatively high. To test this hypothesis, the interaction between PTS symptoms, attentional control, and cognitive load was examined as a predictor of threat-related attentional bias and threat-related attention bias variability. Participants (N = 125 undergraduate students) were randomly assigned to high or low load conditions. Participants completed self-report measures of PTS symptoms, a behavioral measure of attentional control, and a novel task that assessed threat-related attentional bias via eye movements and threat-related attention bias variability via button press. The results of a series of hierarchical regressions showed that attentional control moderated the relationship between PTS symptoms and threat-related attention bias variability in the low, but not high, load condition. This moderation effect was not observed for threat-related attentional bias assessed via eye-tracking. Consistent with theory, under conditions of higher cognitive load, overcontrollers may not be able to use attentional control to consistently regulate threat-related attention. Study findings suggest that it may be important to consider contextual factors that increase cognitive load, as well as individual differences in attentional control, when developing attention bias modification interventions to reduce PTS symptomatology.

Examining the Factor Structure and Incremental Validity of the Barkley Deficits in Executive Functioning Scale - Short Form in a Community Sample.

The Barkley Deficits in Executive Functioning Scale - Short Form (BDEFS-SF; Barkley, 2011) was developed to assess deficits in five facets of executive functioning. Theoretical assumptions surrounding the BDEFS-SF presume that executive dysfunction is an overarching construct that consists of five domain-specific factors (i.e., a hierarchical model; Barkley, 2011). Prior research has supported a correlated five-factor model, but the tenability of hierarchical or bifactor models of the BDEFS-SF have not yet been tested. In the present study (N = 1,120 community adults), confirmatory factor analysis was used to compare four theoretically relevant models of the BDEFS-SF (i.e., one-factor, correlated five-factor, hierarchical, and bifactor models). The bifactor model provided the best fit to the data. However, the general factor accounted for the overwhelming majority of variance in BDEFS-SF scores and none of the domain-specific factors exhibited adequate construct replicability or factor determinancy. Further, the general factor accounted for the overhelming majority of variance in criterion variables (i.e., executive attention and health anxiety); the Organization and Emotion factors accounted for a small amount of unique variance in executive attention and the Emotion factor accounted for a small amount of unique variance in health anxiety. Taken together, study findings suggest that the BDEFS-SF has a strong general factor and independent use of the domain-specific factors is contraindicated.

Development and validation of the Multidimensional Cognitive Attentional Syndrome Scale (MCASS).

The cognitive attentional syndrome (CAS), a multidimensional construct that consists of maladaptive forms of self-regulation, is central to the metacognitive model. Despite the CAS's central importance to the metacognitive model, as well as evidence that components of the CAS are risk factors for the development of emotional disorders, a psychometrically sound self-report measure that accounts for the multidimensional nature of the CAS has yet to be developed. The present set of studies details the development and initial validation of the Multidimensional Cognitive Attentional Syndrome Scale (MCASS). In study 1, a pool of 69 items, assessing the seven self-regulation strategies of the CAS, was administered to U.S. adults recruited through a crowd-sourcing website (N = 323). Structural analyses supported the proposed 7-factor solution and three items with the highest loadings on each factor, without salient cross-loadings, were retained. In Study 2, adult participants (N = 389) completed a battery of self-report measures, including the retained 21 MCASS items. The reduced item pool was examined using both first- and second-order measurement models. The 7-factor first-order measurement model and the second-order measurement model, with each of the first-order factors loading on a higher-order construct (i.e., CAS), provided adequate model fit. Each of the seven, first-order factors exhibited significant loadings on the second-order construct. Convergent, discriminant, and concurrent validity analyses further supported the construct validity of the MCASS scale scores. The MCASS may be particularly useful for examining the theoretical underpinnings of the metacognitive model, as well as for more comprehensive clinical monitoring of the CAS. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Efficacy of third wave cognitive behavioral therapies in the treatment of posttraumatic stress: A meta-analytic study.

The purpose of the present study was to examine, via meta-analysis, the efficacy of third wave therapies in reducing posttraumatic stress (PTS) symptoms. A secondary aim was to identify whether treatment efficacy was moderated by treatment type, treatment duration, use of exposure, use of intent-to-treat samples, and treatment format (i.e., individual, group, both). Risk of bias was also assessed. A literature search returned 37 studies with a pooled sample of 1268 participants that met study inclusion criteria. The mean differences between pre- and post-treatment PTS symptoms were estimated using a random effects model (i.e., uncontrolled effect). Additionally, in a subset of studies that utilized a control condition, a controlled effect in which pre- to post-treatment PTS symptom changes accounted for symptom changes in the control condition was calculated. The overall uncontrolled effect of third wave therapies in reducing PTS symptoms was medium to large (Hedges' g = 0.88 [0.72-1.03]). Treatment type, use of intent-to-treat analysis, inclusion of exposure, and format moderated the uncontrolled effect, but treatment duration did not. The controlled effect of third wave therapies was small to large in size (Hedges' g = 0.50 [0.20-0.80]). Findings suggest that third wave therapies demonstrate enough promise in treating individuals with PTS symptoms to warrant further investigation. Implications and suggestions for future third wave research are discussed.

The interactive effect of event centrality and maladaptive metacognitive beliefs on posttraumatic stress symptoms and posttraumatic growth.

OBJECTIVE: Event centrality, the extent to which a traumatic event becomes a reference point for understanding the world and one's role in it, is related to both posttraumatic stress (PTS) symptoms and posttraumatic growth (PTG). Given that higher event centrality is associated with both of these seemingly disparate postevent trajectories, research on potential moderators of these relationships is needed to better understand the conditions under which event centrality relates to one or both outcomes. Maladaptive metacognitive beliefs (i.e., beliefs about thinking, Wells & Matthews, 1994, 1996) might be one individual difference factor that influences the degree to which event centrality is related to PTS symptoms and PTG. METHOD: In a laboratory session, undergraduate students (N = 149) completed self-report measures of event centrality, maladaptive metacognitive beliefs (negative and positive), PTS symptoms, and PTG. Analyses were conducted using structural equation modeling in order to account for shared variance between PTS symptoms and PTG. RESULTS: As predicted, the positive relationship between event centrality and PTS symptoms became increasingly stronger as maladaptive metacognitive beliefs increased (i.e., both positive and negative metacognitive beliefs). The positive relationship between event centrality and PTG was stronger as maldaptive negative, but not positive, metacognitive beliefs decreased. CONCLUSIONS: Study findings suggest that treatments designed to reduce maladaptive metacognitive beliefs could lead to reductions in PTS symptoms and increased opportunity for PTG among those with highly central traumatic events. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Individual differences in attentional control explain the differential expression of threat-related attentional bias among those with posttraumatic stress symptomatology and predict symptom maintenance up to one year later.

Individual differences in attentional control may explain null findings and inconsistent patterns of threat-related attentional bias (ABT) that are common in the posttraumatic stress disorder (PTSD) literature. At Time 1 (T1), trauma-exposed community participants (N = 89) completed a clinical interview, self-report measures, and an eye-tracking task developed to assess ABT. Participants completed follow-up assessments online 6 (T2) and 12 (T3) months later. Those with higher PTSD symptoms and deficits in attentional control exhibited a pattern of undercontrol, characterized by attention maintenance on threat and increased arousal. In contrast, those with higher PTSD symptoms and relatively better attentional control exhibited a pattern of overcontrol, characterized by threat avoidance and reduced arousal. These effects were specific to threat stimuli. Among PTSD symptom clusters, symptoms of hyperarousal were of central importance to the observed effects. Results from the longitudinal analysis indicate that both of these patterns of ABT are maladaptive, resulting in symptom maintenance at T2 and T3. These results have implications for (a) reconciling tensions between disparate models of ABT (i.e., vigilance-avoidance vs. attention maintenance), (b) precision medicine based approaches to targeting PTSD-related ABT, and (c) understanding the transdiagnostic role that attentional control may play in influencing ABT expression.

The buffering effect of attentional control on the relationship between cognitive fusion and anxiety.

Cognitive fusion has been identified as a risk factor for anxiety. Evidence suggests that those with better attentional control may be able to flexibly shift attention from an internal to external focus, thus reducing contact with negative self-referent thoughts. As such, attentional control was examined as a moderator of the relation between cognitive fusion and anxiety in this two-part study. Adult participants (N = 597) completed self-report measures in Study 1. In Study 2, adult student participants (N = 173) completed self-report measures of cognitive fusion and anxiety, as well as behavioral measures that assessed three specific attentional control processes (i.e., inhibition, shifting, working memory updating). As predicted, attentional control moderated the relation between cognitive fusion and anxiety such that the strength of the relation decreased as attentional control increased. The results of Study 2 suggest that inhibitory ability is the attentional control process that accounts for this effect. Taken together, results suggest the possibility that attentional control (especially inhibitory ability) may be a protective factor against the development of anxiety among those with higher levels of cognitive fusion. The use of experimental and longitudinal study designs will be an important next step in this line of research to further clarify the nature of relations among cognitive fusion, attentional control, and anxiety. Results from an exploratory analysis, in which depressive symptoms served as the outcome variable, will also be discussed.