Positive and negative emotional avoidance as moderators between anxiety sensitivity and posttraumatic stress disorder symptom severity

Anxiety sensitivity (AS) is a set of trait-like dysfunctional beliefs about negative and harmful consequences of anxious arousal (Reiss & McNally, 1985). Research has consistently shown a strong positive association between posttraumatic stress disorder (PTSD) and AS (Naragon-Gainey, 2010; Taylor et al., 1992). Though this correlation is well established, it is largely unknown what moderates this strong association between AS and PTSD. Emotional avoidance (EA) has been suggested to be an emotional regulation process that is common to anxiety disorders and PTSD (Hayes et al., 1999). Naifeh et al. (2012) and Tull et al. (2011) have demonstrated that anxiety-related disorders are associated with both negative emotional avoidance (e.g., avoidance of unpleasant thoughts and feelings) and positive emotional avoidance (e.g., feeling scared/ashamed in response to positive emotions). Several lines of research suggest that the key mechanism behind AS predicting PTSD symptom severity might be the extent to which an individual takes part in the effort to avoid the frequency of unwanted internal experiences, or emotional avoidance (Bardeen et al., 2013; Kashdan et al., 2008). The present study examined the role of positive EA and negative EA as potential moderators of the association between AS and PTSD symptom severity. A total of 434 college students enrolled in a psychology course at a regional public university in the southeastern United States were recruited for participation. Of these, 216 participants with a history of trauma exposure, based on the DSM-5 Criterion A, were retained for subsequent analyses. The PROCESS Macro was used to examine the possible moderating effect of positive and negative emotional avoidance on the relationship between the three subscales of AS and PTSD symptom severity. Although emotional avoidance, anxiety sensitivity, and PTSD symptom severity were all positively correlated and initial regression results were consistent with the hypothesized effects, there were no significant moderating effects. The present study potentially informs the role and measurement of emotional avoidance in the context of posttraumatic stress symptoms and aid in the conceptualization of the trauma-affected populations