The unique impacts of attentional control and experiential avoidance on PTSD symptomatology: Moderation of nonlinear effects

Abstract

Whereas attentional control has been proposed as a broad-based protective factor for PTSD, data suggest that elevated control may be paradoxically associated with increased symptoms, particularly in the presence of other risk factors. The current study examined the unique and interactive effects of attentional shifting (i.e., the transfer of attention across stimuli) and attentional focusing (i.e., the maintenance of attention on relevant targets) with experiential avoidance on posttrauma symptom clusters, accounting for potential nonlinearities in the influence of shifting and focusing dimensions. Shifting models in survivors of heterogeneous trauma (N = 252; 75 % female; 85.7 % White/Non-Hispanic) identified shifting as a moderator of the linear effect of experiential avoidance on CAPS-5 arousal-reactivity (β = −.16, p = .008), with experiential avoidance holding positive associations with arousal-reactivity through shifting scores reaching 2/3SD above the mean. Focusing models, by contrast, identified experiential avoidance as a moderator of the quadratic effect (x²) of focusing on CAPS-5 intrusions (β = .13, p = .010). Data failed to support effects of focusing at low levels of experiential avoidance (-1SD). A curvilinear effect of focusing emerged at average experiential avoidance, however, suggesting reductions in traumatic intrusions with increased focusing to mean values in the sample. At high experiential avoidance (+1SD), intrusions decreased with increases in focusing through average levels, but rebounded in response to focusing capabilities extending beyond the sample mean. Results are consistent with previous research suggesting nonlinearities in the effects of attentional control on posttrauma functioning and point to the importance of specific attentional processes in understanding avenues of risk and resilience.