Contrast avoidance prospectively mediates effects of fear of emotional responding, negative problem orientation, and sensitivity to low perceived control on generalized anxiety disorder symptoms.

The Contrast Avoidance Model (CAM; Newman & Llera, 2011) has been well established in the literature on the etiology and maintenance of generalized anxiety disorder (GAD). Research has investigated other factors that may also characterize GAD, such as fear of emotional responding, negative problem orientation (NPO), and negative beliefs about control; however, these have yet to be explored within the context of the CAM regarding maintenance of GAD symptoms. The purpose of this study was to explore the predictive relationship between the above-mentioned factors and GAD symptoms, mediated by contrast avoidance. Participants (N = 99, 49.5% of whom scored in the upper range on GAD symptoms) completed a series of questionnaires across three time points, each one week apart. Results indicated that fear of emotional responding, NPO, and sensitivity to low perceived control predicted CA tendencies a week later. CA tendencies then mediated the relationship between each predictor and GAD symptoms in the following week. Findings suggested that known vulnerabilities for GAD predict coping with distressing internal responses via sustained negative emotionality (such as through chronic worry) as a way to avoid negative emotional contrasts. However, this coping mechanism itself may maintain GAD symptoms over time.

The reasons dissociative disorder patients self-injure.

Background: Most individuals with dissociative disorders (DDs) report engaging in self-injury. Objective: The present study aimed to understand the reasons for self-injury among a clinical sample of 156 DD patients enrolled in the TOP DD Network study. Method: Participants answered questions about self-injury, including a prompt asking how often they are aware of the reasons they have urges to self-injure, as well as a prompt asking them to list three reasons they self-injure. Results: Six themes of reasons for self-injury, each with subthemes, were identified in the qualitative data: (1) Trauma-related Cues, (2) Emotion Dysregulation, (3) Stressors, (4) Psychiatric and Physical Health Symptoms, (5) Dissociative Experiences, and (6) Ineffective Coping Attempts. Participants reported that they were able to identify their reasons for self-injuring sometimes (60.26%) or almost always (28.85%), with only 3.20% unable to identify any reasons for their self-injury. Conclusion: Results suggest that the vast majority of DD patients (92.31%) reported being at least partially unaware of what leads them to have self-injury urges, and many individuals with DDs experience some reasons for self-injury that are different from those with other disorders. The treatment implications of these findings are discussed.

Antecedentes:La mayoría de los individuos con trastornos disociativos (DDs por sus siglas en inglés) informan realizarse autolesiones. Objetivo: El presente estudio tuvo como objetivo el comprender las razones de las autolesiones en una muestra clínica de 156 pacientes con DD enroladas en el estudio TOP DD Network.Método:Los participantes respondieron a preguntas sobre las autolesiones, incluyendo una pregunta sobre la frecuencia con la que son conscientes de las razones por las que se autolesionan, así como una pregunta que les pedía que enumeraran tres razones por las que se autolesionan.Resultados:En los datos cualitativos se identificaron seis temas de motivos de autolesión, cada uno con subtemas: (1) Claves relacionadas con el trauma, (2) Desregulación emocional, (3) Estresores, (4) Síntomas psiquiátricos y de salud física, (5) Experiencias disociativas y (6) Intentos de afrontamiento ineficaces. Los participantes informaron que pudieron identificar sus razones para autolesionarse a veces (60,26%) o casi siempre (28,85%), y solo el 3,20% no pudo identificar las razones de sus autolesiones.Conclusiones:Los resultados sugieren que la gran mayoría de los pacientes con DD (92.31%) informaron no ser, al menos parcialmente, conscientes de lo que los lleva a tener deseos de autolesionarse y muchos individuos con DDs experimentan algunas razones de autolesión que son distintas de las que padecen otros trastornos. Se discuten las implicaciones de estos hallazgos en el tratamiento.