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Experiential avoidance as a mediator in the relationship between shame and posttraumatic stress disorder: The effect of gender.

OBJECTIVE
The current study sought to investigate whether experiential avoidance (EA) mediates the effect of shame on posttraumatic symptoms (PTS) in a population of trauma-exposed individuals. Given demonstrated gender differences in posttraumatic stress disorder (PTSD), the current cross-sectional study also sought to examine whether gender moderates this mediational proposed effect. EA has been shown to mediate shame and depression symptoms, suggesting that the unwillingness to feel and/or the attempt to control shame may be an important factor in later psychopathological symptoms. Furthermore, EA appears to influence PTS over time.


METHOD
Trauma-exposed undergraduates (n = 326, 68.8% male, Mage = 19.35, SD = 2.30) at a large Midwestern university completed measures of shame, EA, and PTS.


RESULTS
EA was found to fully mediate the relationship between shame and PTS. The role of gender was mixed as it moderated the relationship between EA and PTS such that the effect of EA is stronger for men than women; however, when analyzed with more robust methods, the effect of gender was no longer significant. A competing, flipped mediational model was run to further assess the direction of hypothesized relationships, but shame was not a significant mediator of EA and PTSD symptoms.


CONCLUSIONS
Results provide further evidence for the centrality of EA in maintaining PTS and suggest targeting EA rather than shame in treatment as an avenue for intervention. Future research is needed to investigate gender differences in engagement in EA. (PsycInfo Database Record (c) 2020 APA, all rights reserved).