Category: Addictive Behaviors

PS7- #B44 - Behavioral Avoidance During Recovery From Alcohol and Substance Use Disorders: PTSD Symptoms as a Moderator

Friday, Nov 17
4:00 PM – 5:00 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Addictive Behaviors | Recovery | PTSD (Posttraumatic Stress Disorder)

Research indicates that PTSD and substance use disorders often co-occur. One major component of a PTSD diagnosis is that of avoidance, specifically avoidance of past traumatic memories, reminders of those memories, and other uncomfortable situations Emotional and experiential avoidance are strong in avoiding memories and behavioral avoidance is strong in staying away from situations that cause significant discomfort. Some individuals will try to stay awake as much as possible because they have such strong fear of the nightmares that they believe they will have whenever they fall asleep. Much research on PTSD has shown that such avoidance is a strong factor in the maintenance of PTSD symptoms. Behavioral avoidance is also commonly seen in individuals with substance use disorders without significant PTSD symptoms. Thus, it is plausible that behavioral avoidance is just one cross-cutting component that may aid in treatment of co-morbid substance use disorders and PTSD. Additionally, distress tolerance has been found to predict treatment outcomes in individuals with substance use disorders such that those who can better tolerate distress experience better outcomes in treatment. However, research is lacking in better understanding the nuanced relationship between these behavioral patterns and symptomology within individuals recovering from substance use disorders.


Sixty one abstinent males with a diagnosis of an alcohol or substance use disorder participated at a transitional housing facility. This study examined patient demographics, several measures of avoidant coping styles, distress tolerance, PTSD self-reported symptomology, and data from a completed behavioral avoidance task (Algebra Avoidance Task). Correlation and 2x2 factorial ANOVAs examined the relationships between such variables. A mediation model was hypothesized, such that PTSD symptoms would be related to greater avoidance, worse task performance, lower distress tolerance and explain the relationship between avoidant coping styles and avoidance task performance.


As hypothesized, there was an interaction of PCLC scores (high vs. low) and AAQ scores (high vs. low), as they related to the number of problems attempted on the algebra avoidance task (F(1,56) = 8.459, p = .005, MSe = 4.909). Also as hypothesized, there was an interaction of PCLC scores (high vs. low) and DTS scores (high vs. low), as they related to the number of problems attempted on the algebra avoidance task (F(1,56) = 4.206, p = .045, MSe = 5.388). Further analysis based on LSD follow-ups of the cell means provides further understanding into this interaction.

These results highlight the importance of examining aspects of avoidant coping styles and PTSD symptomology for individuals in treatment for substance use disorders. More research is necessary to replicate and better understand the potential mechanisms that may underlie this behavioral avoidance coping pattern and PTSD co-morbidity within a recovering population.

Jessie Tibbs

Clinical Psychology Graduate Student
University of Nebraska-Lincoln
Lincoln, Nebraska

Alexi Cranford

Clinical Psychology Graduate Student
University of Nebraska-Lincoln
Lincoln, Nebraska

Timothy Little

Research Assistant
University of Nebraska-Lincoln

MJ Schlosser

Research Assistant
University of Nebraska-Lincoln

Dennis McChargue

University of Nebraska-Lincoln