Psychological inflexibility predicts PTSD symptom severity in war veterans after accounting for established PTSD risk factors and personality.

Meyer, Eric C.; La Bash, Heidi; DeBeer, Bryann B.; Kimbrel, Nathan A.; Gulliver, Suzy B.; Morissette, Sandra B.

doi:10.1037/tra0000358

Cited by 74Posttraumatic Stress Disorder ResearchMindfulness and Compassion InterventionsMigration, Health and Trauma

Psychological inflexibility predicts PTSD symptom severity in war veterans after accounting for established PTSD risk factors and personality.

Meyer, Eric C., La Bash, Heidi, DeBeer, Bryann B., Kimbrel, Nathan A., Gulliver, Suzy B., Morissette, Sandra B.·2019·Psychological Trauma: Theory, Research, Practice, and Policy

DOI 10.1037/tra0000358

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Abstract

OBJECTIVE AND METHOD: Numerous risk factors for posttraumatic stress disorder (PTSD) have been identified; however, many do not inform treatment. Psychological inflexibility is a modifiable factor that can be targeted in psychological treatment. This study examined whether higher levels of psychological inflexibility predicted unique variance in PTSD symptom severity at 1-year follow-up in 236 U.S. veterans of the wars in Iraq in Afghanistan after accounting for the strongest known risk factors for PTSD. PTSD symptom severity was assessed using the Clinician Administered PTSD Scale. RESULTS: In hierarchical regression analyses, higher baseline psychological inflexibility predicted unique variance in 1-year PTSD symptom severity (p < .001, medium effect) after accounting for the strongest predictors, including: serving in the Army, rank, trauma severity, perceived threat, peritraumatic dissociation, recent life stress, and social support. Psychological inflexibility remained a significant predictor of unique variance in 1-year PTSD symptom severity after accounting for all other predictors and personality factors (neuroticism, extroversion, openness to experience, agreeableness, and conscientiousness; p < .001, small effect) and after accounting for all other predictors, personality factors, and baseline PTSD avoidance symptoms (p < .001; small effect). CONCLUSIONS: Findings indicate a key unique association between psychological inflexibility and PTSD symptom severity over time that is not attributable to overlap with personality or PTSD avoidance symptoms. Additional research on psychological inflexibility in the development and maintenance of PTSD is warranted, as well as whether increasing psychological flexibility leads to reductions in PTSD symptoms and improved psychosocial functioning. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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Experiential avoidance is a common factor underlying a number of clinical disorders.
“Research has shown that experiential avoidance is a common factor underlying a number of clinical disorders and contributes to posttraumatic stress symptomatology (Akbari et al., 2022; Meyer et al., 2019).”
From Group-Based Acceptance and Commitment Therapy for PTSD in a HMO Psychiatry Clinic: An Open Trial (2024) · cites this paper as Meyer et al., 2019
Experiential avoidance contributes to posttraumatic stress symptomatology.
“Research has shown that experiential avoidance is a common factor underlying a number of clinical disorders and contributes to posttraumatic stress symptomatology (Akbari et al., 2022; Meyer et al., 2019).”
From Group-Based Acceptance and Commitment Therapy for PTSD in a HMO Psychiatry Clinic: An Open Trial (2024) · cites this paper as Meyer et al., 2019
Strong associations between experiential avoidance and NNE, along with the negative impact of experiential avoidance on mental health symptoms, have been extensively documented.
“The strong associations between experiential avoidance and NNE, along with the negative impact of experiential avoidance on mental health symptoms have been extensively documented (63–68).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [67]

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Authors: Meyer, E. C., La Bash, H., DeBeer, B. B., Kimbrel, N. A., Gulliver, S. B., & Morissette, S. B.
Affiliations: VA Heart of Texas Health Care Network (US)
Veterans Health Administration (US)
ORCID: Meyer, Eric C.
DeBeer, Bryann B.
Kimbrel, Nathan A.
Gulliver, Suzy B.
Morissette, Sandra B.
Venue: Psychological Trauma: Theory, Research, Practice, and Policy
Publisher: American Psychological Association (APA)
Published: 2019-05
Volume: 11
Issue: 4
Pages: 383-390
ISSN: 1942-9681 (ISSN-L)
1942-969X
DOI: 10.1037/tra0000358
OpenAlex: W2888813440
Cited by: 74
References: 39
Citations by year: 2026: 6 · 2025: 14 · 2024: 5 · 2023: 12 · 2022: 10 · 2021: 11 · 2020: 8 · 2019: 5 · 2018: 3
FWCI: 7.92
Type: journal article
Language: en
Open access: closed
Locations: Psychological Trauma Theory Research Practice and Policy (publishedVersion)
PubMed (publishedVersion)
Funders: US Department of Veterans Affairs (I01RX000304-01A1, I01RX000304-04A1)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords: psychological inflexibility, post-traumatic stress disorder, PTSD symptom severity, war veterans, Iraq and Afghanistan wars, PTSD risk factors, personality traits, psychological flexibility, peritraumatic dissociation, threat perception, social support, life events
MeSH terms: Adult, Female, Follow-Up Studies, Humans, Interview, Psychological, Longitudinal Studies, Male, Mental Processes, Middle Aged, Personality, Personality Tests, Prognosis, Psychiatric Status Rating Scales, Risk Factors, Severity of Illness Index, Stress Disorders, Post-Traumatic, Veterans, Iraq War, 2003-2011, Young Adult, Afghan Campaign 2001-

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Psychological inflexibility predicts PTSD symptom severity in war veterans after accounting for established PTSD risk factors and personality.

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