ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Atadokht   A. (1)
Einy   S. (*)
Tagavy   R. (2)






(*) Psychology Department, Educational Sciences & Psychology Faculty, Mohaghegh Ardabili University, Ardabil, Iran
(1) Psychology Department, Educational Sciences & Psychology Faculty, Mohaghegh Ardabili University, Ardabil, Iran
(2) Psychology Department, Psychology Faculty, Ardabil Branch, Islamic Azad University, Ardabil, Iran

Correspondence

Address: Psychology & Educational Sciences Faculty, University of Mohaghegh Ardabili, Daneshgah Street, Ardabil, Iran
Phone: +98 (45) 33262678
Fax: +98 (45) 33511508

Article History

Received:   September  27, 2017
Accepted:   January 11, 2017
ePublished:   April 10, 2018

ABSTRACT

Aims The sensitivity of behavioral activation and inhibition systems can play a role in the continuation of post-traumatic stress disorder (PTSD) in veterans. Regarding the importance of this issue, the present study was conducted with the aim of predicting the impulsivity and experiential avoidance of veterans with post-traumatic stress disorder based on the activation and behavioral inhibition systems.
Instrument & Methods In the present descriptive correlational study, 120 veterans with post-traumatic stress disorders, hospitalized in Isar Psychiatric Hospital in Ardabil were selected, using available sampling method in 2017. The data were collected, using Behavioral Activation and Inhibition Systems Scale, Impulsivity questionnaire, and Acceptance and Action questionnaire. The data were analyzed by SPSS 21 software, using Pearson correlation coefficient and multiple regression analysis
Findings A total of 65.4% of the experiential avoidance variance and 79.1% of the impulsivity variance of veterans with PTSD were determined by behavioral activation and inhibition systems (p=0.001). Behavioral inhibition system (β=0.167) and sensitivity to reward (β=0.66) predicted experiential and avoidance significantly (p<0.001). Also, sensitivity to reward (β=0.366), directly and significantly, and behavioral inhibition (β=-0.132), inversely and significantly, predicted the impulsivity of veterans with PTSD (p<0.001).
Conclusion The sensitivity of the behavioral activation and inhibition systems increases the experiential avoidance and impulsivity in the veterans with PTSD. Thus, by reducing the activity of brain/behavioral systems, it is possible to modulate experiential avoidance, impulsivity, and PTSD symptoms in veterans.

Keywords: Experiential Avoidance , Behavioral Activation and Inhibition Systems , Impulsivity, Post-traumatic Stress Disorder , Veteran,

CITATION LINKS

[1]Zooghi-Paydar MR. The effect of cognitive-behavioral couple therapy on post-traumatic stress disorder and depression in veterans. J Woman Fam Stud. 2013;1(1):99-118. [Persian]
[2]American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-5. 5th Edition. Rezaei F, Fakhraee A, Farmand A, Niloofari A, Hashemi Azar J, Shamloo F, translators. Tehran: Arjmand; 2013. p. 102-9. [Persian]
[3]Kamalmanesh A, Maredpour A. Evaluation of post-traumatic stress disorder among war survivors. Health Res J. 2017;2(2):87-98. [Persian]
[4]Morina N. The role of experiential avoidance in psychological functioning after war-related stress in Kosovar civilians. J Nerv Ment Dis. 2007;195(8):697-700.
[5]Hershenberg R, Mavandadi S, Wright E, Thase ME. Anhedonia in the daily lives of depressed veterans: A pilot report on experiential avoidance as a moderator of emotional reactivity. J of Affect Disord. 2017;208:414-7.
[6]Eifert GH, Forsyth JP, Arch J, Espejo E, Keller M, Langer D. Acceptance and commitment therapy for anxiety disorders: Three case studies exemplifying a unified treatment protocol. Cogn Behav Pract. 2009;16(4):368-85.
[7]Karekla M, Panayiotou G. Coping and experiential avoidance: Unique or overlapping constructs?. J Behav Ther Exp Psychiatry. 2011;42(2):163-70.
[8]Sloan DM. Emotion regulation in action: Emotional reactivity in experiential avoidance. Behav Res Ther. 2004;42(11):1257-70.
[9]Shenk CE, Putnam FW, Noll JG. Experiential avoigance and the relationship between child maltreatment and PTSD symptom: Preliminary evidence. Child Abuse Negl. 2012;36(2):118-26.
[10]Basharpoor S, Shafiei M, Atadokht A, Narimani M. The role of experiential avoidance and mindfulness in predicting the symptoms of stress disorder after exposure to trauma in traumatized people supported by Emdad Committee and Bonyade Shahid organization of Gilan Gharb in the First half of 2014. J Rafsanjan Univ Med Sci. 2015;14(5):405-16. [Persian]
[11]Bakhshaie J, Zvolensky MJ, Allan N, Vujanovic AA, Schmidt NB. Differential effects of anxiety sensitivity components in the relation between emotional nonacceptance and post-traumatic stress symptoms among trauma-exposed treatment-seeking smokers. Cogn Behav Ther. 2015;44(3):175-89.
[12]Bardeen JR, Fergus ThA. The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumatic stress symptoms. J Context Behav Sci. 2016;5(1):1-6.
[13]Cobb AR, Lancaster CL, Meyer EC, Lee HJ, Telch MJ. Pre-deployment trait anxiety, anxiety sensitivity and experiential avoidance predict war-zone stress-evoked psychopathology. J Context Behav Sci. 2017;6(3):276-87.
[14]James LM, Strom TQ, Leskela J. Risk-taking behaviors and impulsivity among veterans with and without PTSD and mild TBI. Mil Med. 2014;179(4):357-63.
[15]Basharpoor S. Personality Trait (theory and testing). 1st Edition, Tehran: Savalan; 2015. [Persian]
[16]Gullo MJ, Dawe S. Impulsivity and adolescent substance use: Rashly dismissed as ‘‘all-bad’’?. Neurosci Biobehav Rev. 2008;32(8):1507-18.
[17]Mirdoraghi F, Ghanbary Hashemabady B, Mashhadi A. Cognitive and behavioral inhibition in veterans with- and without post-traumatic stress disorder. J Mil Med. 2012;14(1):41-7. [Persian]
[18]Netto LR, Pereira JL, Nogueira JF, Cavalcanti-Ribeiro P, Santana RC, Teles CA, et al. Impulsivity is relevant for trauma exposure and PTSD symptoms in a non-clinical population. Psychiatry Res. 2016;239:204-11.
[19]Tull MT, Barrett HM, McMillan ES, Roemer L. A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behav Ther. 2007;38(3):303-13.
[20]Ehring T, Quack D. Emotion regulation difficulties in trauma survivors: The role of trauma type and PTSD symptom severity. Behav Ther. 2010;41(4):587-98.
[21]Hafezi F, Khajuni A. The effect of anger management skill training on reduction of impulsive behaviors and anxiety in patients with PTSD. J Soc Psychol. 2012;5(20):89-107. [Persian]
[22]Bjork JM, Burroughs TK, Franke LM, Pickett TC, Johns SE, Moeller FG, et al. Rapid-response impulsivity predicts depression and posttraumatic stress disorder symptomatology at 1-year follow-up in blast-exposed service members. Arch Phys Med Rehabil. 2017;98(8):1646-51.
[23]Gray JA, McNaughton N. The neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampus system. 2nd Edition. New York: Oxford University Press; 2000.
[24]Kalantari H, Bagherian-Sararoudi R, Babaeipour E. Comparison study of behavioral activation system and behavioral inhibition system in irritable bowel syndrome patients and normal individuals. J Babol Univ Med Sci. 2012;14(2):59-65. [Persian]
[25]Myers CE, VanMeenen KM, Servatius, RJ. Behavioral inhibi-tion and PTSD symptoms in veterans. Psychiatry Res. 2012;196(2-3):271-6.
[26]Pickett SM, Bardeen JR, Orcutt HK. Experiential a voidance as a moderatore of the relationship between behaviore inhibitiion system sensitivity and posttraumatic stress symptom. J Anxiety Disord. 2011;25(8):1038-46.
[27]Contractor A, Elhai JD, Ractliffe KC, Forbes D. PTSD's underlying symptom dimensions and relations with behavioral inhibition and activation. J Anxiety Disord. 2013;27(7):645-51.
[28]Delavar A. Theoretical and practical research in the humanities and social sciences. Teharn: Roshd; 2009. [Persian]
[29]Carver CS, White TL. Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS scales. J Personal Soc Psychol. 1994;67(2):319-33.
[30]Muris P, Meesters C, Spinder M. Relationships between child-and parent-reported behavioural inhibition and symptoms of anxiety and depression in normal adolescents. Personal Individ Differ. 2005;34:759-71.
[31]Abdollahi R, Bakhshipour R, Mahmoodaliloo M. Validity and reliability of behavioral inhibition and activation systems (BIS/BAS) scales among Tabriz university students. J Manag Syst. 2013;7(28):123-39. [Persian]
[32]Basharpoor S, Barahmand U, Molavi P, Mousavi SA. The relationship between behavioral activation/inhibition systems (BAS/BIS) and bullying/victimization behaviors among male adolescents. Iran J Psychiatry. 2013;8(3):118-23.
[33]Barratt ES, Stanford MS, Kent TA, Felthous A. Neuropsychological and cognitive psychophysiological substrates of impulsive aggression. Biol Psychiatry. 1997;41(10):1045-61.
[34]Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol. 1995;51(6):768-74.
[35]Javid M, Mohammadi N, Rahim CH. Psychometric properties of an Iranian version of the Barratt impulsiveness scale-11 (BIS-11). J Manage Syst. 2012;(8):23-34. [Persian]
[36]Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011;42(4):676-88.
[37]Abbasi I, Fati L, Moludi R, Zarrabi H. Psychometric properties of Persian version of acceptance and action questionnaire-II. J Psychol Model Method. 2013;3(10):65-80. [Persian]
[38]Maack DJ, Tull MT, Gratz KL. Experiential avoidance mediates the association between behavioral inhibition and post-traumatic stress disorder. Cogn Ther Res. 2011;36:407-16.
[39]Weiss NH, Tull MT, Viana AG, Anestis MD, Gratz KL. Impulsive behaviors as an emotion regulation strategy: Examining associations between PTSD, emotion dysregulation, and impulsive behaviors among substance dependent inpatients. J Anxiety Disord. 2012;26(3):453-8.