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Approach-avoidance coping conflict in a sample of burn patients at risk for posttraumatic stress disorder.

Abstract：

BACKGROUND:Following an acute burn injury, higher distress is consistently observed among individuals exhibiting a conflict between approach coping (e.g., processing) and avoidance coping (e.g., suppression) relative to those individuals who use only one of these methods. Study objectives were to determine if contradictory coping messages would lead to such approach-avoidance coping conflict and to determine if experiment-induced coping conflict is also associated with higher distress. METHODS:Participants (n=59 adults hospitalized with acute burn injuries) were assigned randomly to experimental conditions differing in the order in which training was provided in two ways of coping with posttrauma re-experiencing symptoms (i.e., process-then-suppress versus suppress-then-process). The primary dependent variable was coping behavior during the 24-hr posttraining period. Coping behavior was categorized as approach coping (processing), avoidance coping (suppressing), or approach-avoidance coping conflict (both) on the basis of median splits on subscales assessing these behaviors. Secondary analyses examined the relationship between this experiment-induced coping conflict and re-experiencing symptoms. RESULTS:Results indicated that participants in the process-then-suppress condition, relative to the suppress-then-process condition, were significantly more likely to exhibit approach-avoidance coping conflict (i.e., above median split on both processing and suppressing) during the next 24 hr. Furthermore, approach-avoidance coping conflict was associated with greater re-experiencing symptoms assessed via self-report and by blinded coding of recorded speech. CONCLUSIONS:It is concluded that the order of coping skill training can influence treatment outcome, success of coping methods, and overall levels of distress. therefore, training in stabilizing and calming methods should precede training in active processing following stressful life events.

journal_name

Depress Anxiety

journal_title

Depression and anxiety

authors

Fauerbach JA,Lawrence JW,Fogel J,Richter L,Magyar-Russell G,McKibben JB,McCann U

doi

10.1002/da.20439

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

838-50

issue

9

eissn

1091-4269

issn

1520-6394

journal_volume

26

pub_type

杂志文章,随机对照试验

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