Acceptance and Commitment Therapy (ACT) is based on the idea that psychological inflexibility creates and exacerbates human suffering (Hayes et al., 2012). Two interrelated processes that are central to psychological inflexibility are experiential avoidance and cognitive fusion. Hayes et al. (2012) proposed that the combination of these two processes forms the closed response style. Bardeen and Fergus (2016) found an interaction between experiential avoidance and cognitive fusion in relation to multiple indices of psychological symptoms, including posttraumatic stress symptoms. Extending extant research, we examined whether the closed response style related to posttraumatic stress symptoms among women with sexual trauma exposure. This population was of notable interest given that exposure to sexual trauma is a common problem among women, particularly on college campuses (Fisher et al., 2000). Based upon Bardeen and Fergus’s (2016) findings, it was predicted that a closed response style can further our understanding of posttraumatic stress among women with sexual trauma exposure.
The sample was 136 women attending a southern U.S. university who reported sexual trauma exposure that involved actual or threatened death, serious injury, or sexual violence on the Life Events Checklist for Diagnostic and Statistical Manual of Mental Disorders–5 (LEC-5; Weathers et al., 2013). Participants reported that the sexual trauma was the most distressing experienced event on the LEC-5. Participants had a mean age of 19 years (SD = 1.4), while primarily self-identifying as white (61.0%), Latino (14.0%), multi-racial (11.0%), or black (9.6%). Participants completed psychometrically-sound self-report measures of experiential avoidance, cognitive fusion, trait anxiety, and posttraumatic stress symptoms (Cronbach’s α > .80).
Hierarchical multiple linear regressions were used to examine study predictions. The predicted interaction between experiential avoidance and cognitive fusion accounted for unique variance in posttraumatic stress symptom scores (ΔR2 = .04, partial r = .25, p = .004) beyond the respective main effects and covariates (trait anxiety, number of endorsed LEC-5 traumatic events, length of time since sexual trauma, and frequency of sexual trauma exposure). Simple effects indicated that experiential avoidance (partial r = .23, p = .007) and cognitive fusion (partial r = .23, p = .009) only shared associations with posttraumatic stress symptoms when coupled with high levels of the other process (i.e., cognitive fusion or experiential avoidance, respectively). These results provide support for proposals suggesting that college women who have been exposed to sexual trauma and demonstrate a closed response style may be particularly likely to experience posttraumatic stress.