Document Type

Dissertation

Degree

Doctor of Philosophy

Major

Psychology, Clinical-Community

Date of Defense

7-15-2025

Graduate Advisor

Steven Bruce, Ph.D.

Committee

Michael Griffin, Ph.D.

Wilson Brown, Ph.D.

Ryan Carpenter, Ph.D.

Abstract

Avoidance is a well-established mechanism in the development and maintenance of posttraumatic stress disorder (PTSD) and a central treatment target in gold standard evidence-based interventions. While traditionally defined as avoidance of trauma-related distressing thoughts, emotions, and reminders, emerging research highlights the need for a broader conceptualization of posttraumatic avoidance that includes both negative and positive emotional experiences. The current study aimed to explore an expanded conceptualization of clinically relevant posttraumatic avoidance using an experiential avoidance framework, a more generally defined unwillingness to remain in contact with distressing thoughts, feelings, memories, and other internal experiences. A sample of non-treatment seeking U.S.-based trauma-exposed adults (N = 669) were recruited through MTurk to complete a series of self-report questionnaires. The established Multidimensional Experiential Avoidance Questionnaire (MEAQ) was first evaluated for fit within this sample of trauma-exposed adults However, confirmatory factor analysis failed to adequately replicate the MEAQ’s original factor structure for use in this trauma-exposed, non-clinical convenience sample. Next, building on the MEAQ, a novel experiential avoidance-based measure including both negative and positive internal experiences was investigated. With the addition of items recruited to capture positive emotion avoidance to the original pool of MEAQ items, exploratory factor analyses supported a three-factor model structure within the present sample of trauma-exposed adults. Strong initial psychometric support was found for the resulting MEAQ-extended measure, which broadens the construct coverage of the well-established experiential avoidance assessment to include positive emotional avoidance. Relationships among each of the three factor subscales of the MEAQ-extended, Positive Experiential Avoidance, Negative Experiential Avoidance, and Distress Endurance, and common posttraumatic psychological symptoms and functional outcomes (PTSD symptom severity, depression symptom severity, problematic alcohol use, chronic pain, and quality of life) were explored, providing additional preliminary support for the clinical utility of the proposed MEAQ-extended. Results of the present study offer a more nuanced and clinically relevant tool for trauma-focused research and intervention, holding important implications for conceptualization, measurement, and treatment in the field of posttraumatic recovery.

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