Mindfulness and Acceptance as Predictors of Response toTrauma Memory Activation
Script-driven imagery (SDI) is a research methodology that has been used to examine trauma survivors' responses to activation of trauma memories, but few studies have examined factors that predict participants' risk of experiencing psychological distress during SDI. The present study investigated the association between trait mindfulness, experiential avoidance, distress tolerance, and reactions to SDI among 18 women who had experienced interpersonal violence in adulthood. Participants who met eligibility criteria were scheduled for participation in the 2-day study and assigned to receive consent as usual or enhanced consent, which included procedures designed to increase understanding of the study. Participants completed baseline questionnaires assessing the three mindfulness and acceptance variables, as well as negative affect, state anger, depression, and dissociation. Afterwards, they were interviewed about their trauma history, as well as the subjective experience of and PTSD symptoms related to their index trauma. These interviews were used to develop a 2-minute individualized trauma script, which participants listened to repeatedly on Day 2 of the study. Following SDI, they completed the same psychological symptom measures administered at baseline, as well as assessments of emotional valence and arousal, PTSD symptom severity, and reactions to the research procedures. As predicted, analyses revealed that lower trait mindfulness and distress tolerance and greater experiential avoidance were associated with greater PTSD symptom severity at baseline. Additionally, after controlling for baseline ratings on psychological symptom measures, greater trait mindfulness was associated with higher ratings of emotional arousal and lower ratings of trauma-related avoidance at post-SDI, while greater distress tolerance was associated with higher ratings of emotional arousal, less negative affect, and less depressive symptomatology. No significant associations were found between experiential avoidance and psychological symptoms at post-SDI. These findings indicate that assessing trait mindfulness and distress tolerance may help to identify those participants at risk of experiencing greater psychological distress during SDI. Furthermore, greater trait mindfulness predicted lower dissociation and lower PTSD symptom severity at post-SDI within the enhanced consent condition alone, suggesting that enhanced consent may have promoted a more open and nonjudgmental orientation to experience among women who were high in trait mindfulness.
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