EL MALESTAR EMOCIONAL COMO SINTOMA DE ESTRES POSTRAUMATICO

(especial para SIIC © Derechos reservados)
En apoyo a la información empírica precedente, los hallazgos de este estudio inciden en el papel de la evitación experiencial y la tolerancia al malestar como variables moderadoras de la sintomatología postraumática. Asimismo, apuntan hacia la necesidad de considerar estas variables en las intervenciones psicológicas para el tratamiento del trastorno por estrés postraumático.
Autor:
Alicia eva López-martínez
Columnista Experta de SIIC

Institución:
Universidad de Málaga (España). Dpto. Personalidad, Evaluación y Tratamiento Psicológico.


Artículos publicados por Alicia eva López-martínez
Artículo comentado
Johana Acosta-Quiroz
Universidad Nacional Pedro Ruiz Gallo, Facultad de Ciencias Biológicas
Coautores
María Algarra Costela* Elena Rocío Serrano Ibáñez** Gema Teresa Ruiz Párraga** Carmen Ramírez Maestre** Rosa Esteve*** 
Psicóloga, Universidad de Málaga, España*
Psicóloga, Universidad de Málaga, Málaga, España**
Psicologa, Universidad de Málaga, Málaga, España***
Recepción del artículo
3 de Mayo, 2019
Aprobación
18 de Septiembre, 2019
Primera edición
23 de Septiembre, 2019
Segunda edición, ampliada y corregida
2 de Septiembre, 2022

Resumen
El trastorno por estrés postraumático (TEPT) tiene una importante prevalencia en la población, por lo que conocer los mecanismos psicológicos para la vulnerabilidad y el mantenimiento del trastorno es claramente relevante. Entre dichos mecanismos, se ha postulado el constructo de malestar emocional como transdiagnóstico a diversos trastornos mentales. El objetivo del presente estudio fue poner a prueba un modelo hipotético que analizaba la asociación entre tres variables pertenecientes a dicho constructo (evitación experiencial, tolerancia al malestar e intolerancia a la incertidumbre inhibitoria) y el TEPT. Participaron 328 estudiantes universitarios (74.7% mujeres y 25.3% hombres, con una media de edad de 21 años) que habían experimentado al menos un acontecimiento traumático de acuerdo con los criterios del DSM-5, quienes completaron una batería de cuestionarios. Se efectuó un análisis de ecuaciones estructurales cuyos resultados apoyaron parcialmente el modelo hipotético. La evitación experiencial mostró asociarse positiva y significativamente con la tolerancia al malestar, la intolerancia a la incertidumbre inhibitoria y los síntomas del TEPT. La tolerancia al malestar también se vinculó de forma positiva y significativa con dichos síntomas. Sin embargo, la intolerancia a la incertidumbre inhibitoria no mostró relación con esta sintomatología. En apoyo a la evidencia empírica precedente, los hallazgos de este estudio inciden en el papel de la evitación experiencial y la tolerancia al malestar como variables moderadoras de la sintomatología postraumática. Asimismo, apuntan hacia la necesidad de considerar estas variables en las intervenciones psicológicas para el tratamiento del TEPT.

Palabras clave
trastorno de estrés postraumático, malestar emocional, evitación experiencial, tolerancia al malestar, intolerancia a la incertidumbre


Artículo completo

(castellano)
Extensión:  +/-6.31 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Abstract
Post-traumatic stress disorder or PTSD has an important prevalence in the population, so knowing the psychological mechanisms of vulnerability and maintenance of this disorder is clearly relevant. Among those mechanisms, the emotional distress construct has been postulated as a trans-diagnostic tool related to different mental disorders. The objective of the present study was to test a hypothetical model for the analysis of the association between three variables of this construct (experiential avoidance, distress tolerance, and inhibitory uncertainty intolerance) and PTSD. The subjects of study amounted to 328 university students (74.7% women and 25.3% men, with a median age of 21) who had experienced at least one traumatic event according to the DSM-5 criteria. They were made to complete a set of questionnaires. A structural equation analysis was carried out, with results partially coincident with the hypothetical model. Exponential avoidance showed a positive and significant association with distress tolerance, inhibitory uncertainty intolerance and PTSD symptoms. Distress tolerance was also associated with these symptoms in a positive and significant way. However, inhibitory uncertainty intolerance was not associated with this symptomatology. Following the preexisting empirical evidence, the findings of this study have an impact on the role of experiential avoidance and distress tolerance, as variables that moderate post-traumatic symptomatology. Furthermore, the findings point to the need to consider these variables in psychological interventions for the treatment of PTSD.

Key words
posttraumatic stress disorder, emotional distress, experiential avoidance, distress tolerance, intolerance of uncertainty


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Atención Primaria, Salud Mental
Relacionadas: Atención Primaria, Epidemiología, Medicina Familiar, Salud Pública



Comprar este artículo
Extensión: 6.31 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Enviar correspondencia a:
Alicia E. López-Martínez, 29071, Facultad de Psicología. Universidad de Málaga. Campus de Teatinos, s/n, Málaga, España
Bibliografía del artículo
1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: APA, 2013.
2. Flett RA, Kazantzis N, Long NR, MacDonald C, Millar, M. Traumatic events and physical health in a New Zealand community sample. J Traum Stress 15:303-312, 2002.
3. Frans Ö, Rimmö PA, Åberg L, Fredrikson M. Trauma exposure and post-traumatic stress disorder in the general population. Acta Psych Scan 111:291, 2005.
4. Kessler RC, Berglund P, Demler O, Jin R, Merikangas K R, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psych 62:593-602, 2005.
5. Watson SB, Haynes SN. Brief screening for traumatic life events in female university health service patients. Int J Clin Health Psychol 7:261-282, 2007.
6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: APA, 2000.
7. Barlow DH, Allen LB, Choate ML. Toward a unified treatment for emotional disorders. Behav Ther, 35:205, 2004.
8. Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K. Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. J Consul Clin Psycho 64:1152-1168, 1996.
9. Jacoby RJ, Abramowitz JS, Reuman L, Blakey SM. Enhancing the ecological validity of the Beads Task as a behavioral measure of intolerance of uncertainty. J Anxiety Dis, 41:43-49, 2016.
10. Leyro TM, Zvolensky MJ, Bernstein A. Distress tolerance and psychopathological symptoms and disorders: a review of the empirical literature among adults. Psychol Bull, 136:576, 2010.
11. Bardeen JR, Fergus TA, Wu KD. The interactive effect of worry and intolerance of uncertainty on posttraumatic stress symptoms. Cog Ther Res, 37:742-751, 2013.
12. Zvolensky MJ, Vujanovic AA, Bernstein A, Leyro T. Distress tolerance: Theory, measurement, and relations to psychopathology. Association Psychol Science, 19:406-410, 2010.
13. Carleton RN. Into the unknown: a review and synthesis of contemporary models involving uncertainty. J Anxiety Dis, 39:30-43, 2016.
14. Carleton RN, Mulvogue MK, Thibodeau MA, McCabe RE, Antony MM, Asmundson GJ. Increasingly certain about uncertainty: intolerance of uncertainty across anxiety and depression. J Anxiety Dis 26:468-479, 2012.
15. Fetzner MG, Horswill SC, Boelen PA, Carleton RN. Intolerance of uncertainty and PTSD symptoms: exploring the construct relationship in a community sample with a heterogeneous trauma history. Cog Ther Res 37:725-734, 2013.
16. Hong RY, Lee SSM. Further clarifying prospective and inhibitory intolerance of uncertainty: factorial and construct validity of test scores from the Intolerance of Uncertainty Scale. Psychol Assess 27:605-620, 2015.
17. Carleton RN, Norton M, Asmundson GJ. Fearing the unknown: a short version of the Intolerance of Uncertainty Scale. J Anxiety Dis 21:105-117, 2007.
18. Marx BP, Sloan DM. Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology. Behav Res Ther, 43: 569-583, 2005.
19. Biglan A, Hayes SC, Pistorello J. Acceptance and commitment: Implications for prevention science. Prevent Science 9:139-152, 2008.
20. Gratz KL, Bornovalova MA, Delany-Brumsey A, Nick B, Lejuez CW. A laboratory-based study of the relationship between childhood abuse and experiential avoidance among inner-city substance users: the role of emotional nonacceptance. Behav Ther 38:256-268, 2007.
21. Orcutt HK, Pickett SM, Pope EB. Experiential avoidance and forgiveness as mediators in the relation between traumatic interpersonal events and posttraumatic stress disorders symptoms. J Social Clin Psych 24:1003-1029, 2005.
22. Orsillo SM, Batten SV, Plumb JC, Luterek JA, Roessner BM. An experimental study of emotional responding in women with posttraumatic stress disorder related to interpersonal violence. J Traum Stress 17:241, 2004.
23. Plumb JC, Orsillo SM, Luterek JA. A preliminary test of the role of experiential avoidance in post-event functioning. J Behav Ther Expe Psych 35:245-257, 2004.
24. Banducci AN, Connolly KM, Vujanovic AA, Álvarez J, Bonn-Miller MO. The impact of changes in distress tolerance on PTSD symptoms severity post-treatment among veterans in residential trauma treatment. J Anxiety Dis 47:99-105, 2017.
25. Farris SG, Vujanovic AA, Hogan J, Schmidt NB, Zvolensky MJ. Main and interactive effects of anxiety sensitivity and physical distress intolerance with regard to PTSD symptoms among trauma-exposed smokers. J Traum Dissoc 15:254, 2014.
26. Vujanovic AA, Rathnayaka N, Amador CD, Schmitz JM. Distress tolerance: associations with posttraumatic stress disorder symptoms among trauma-exposed, cocaine-dependent adults. Behav Mod 40:120-143, 2016.
27. Ruiz FJ, Langer-Herrera A I, Luciano C, Cangas AJ, Beltrán I. Measuring experiential avoidance and psychological inflexibility: The Spanish version of the Acceptance and Action Questionnaire - II. Psicothema 25:123-129, 2013.
28. Sandín B, Simons JS, Valiente RM, Simons RM, Chorot P. Psychometric properties of the Spanish version of the distress tolerance scale and its relationship with personality and psychopathological symptoms. Psicothema 29:421-428, 2017.
29. Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD. Disponible en: https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp. Consultado el 20 de enero de 2019.
30. Byrne B. Structural equation modelling with AMOS. Londres: L.E.A, 2010.
31. Ullman JB. Structural equation modelling. In BG Tabachnick, LS Fidell (eds.). Using multivariate statistics (pp. 653-711). Needham Heights: Allyn and Bacon, 2001.
32. Kline RB. Principles and practice of structural equation modelling. New York: Guilford Press, 2005.
33. Batten SV, Follette VM, Aban IB. Experiential Avoidance and High-Risk Sexual Behavior in Survivors of Child Sexual Abuse. J Child Sex Abuse 10:101-120, 2002.
34. Mayou RA, Ehlers A, Bryant B. Posttraumatic stress disorder after motor vehicle accidents: 3 year follow-up of a prospective longitudinal study. Behav Res Ther 40:665-675, 2002.
35. Rosenthal MZ, Hall MLR, Palm KM, Batten SV, Follette VM. Chronic avoidance helps explain the relationship between severity of childhood sexual abuse and psychological distress in adulthood. J Child Sex Abuse 14:25-41, 2005.
36. Hayes SC, Strosahl KD, Wilson KG. Acceptance and Commitment Therapy. An experiential approach to behavior change. New York: Guilford Press, 1999.
37. Anestis MD, Tull MT, Bagge CL, Gratz KM. The moderating role of distress tolerance in the relationship between posttraumatic stress disorder symptom clusters and suicidal behavior among trauma exposed substance users in residential treatment. Arch Suicide Res 16:198-211, 2012.
38. Oglesby ME, Boffa JW, Short NA, Raines AM, Schmidt NB. Intolerance of uncertainty as a predictor of posttraumatic stress symptoms following a traumatic event. J Anxiety Dis 41:82-87, 2016.
39. Oglesby ME, Gibby BA, Mathes BM, Short NA, Schmidt NB. Intolerance of uncertainty and posttraumatic stress symptoms: An investigation within a treatment seeking trauma-exposed sample. Compreh Psych 72:34-40, 2017.
40. Banducci AN, Bujarski SJ, Bonn-Miller MO, Patel A, Connolly KM. The impact of intolerance of emotional distress and uncertainty on veterans with co-occurring PTSD and substance use disorders. J Anxiety Dis 41:73-81, 2016.
41. Fourtounas A, Thomas SJ. Cognitive factors predicting checking, procrastination and other maladaptive behaviours: Prospective versus Inhibitory Intolerance of Uncertainty. J Obsessive-Compulsive Related Dis 9:30-35, 2016.
42. Green BL. Psychosocial research in traumatic stress: An update. J Traum Stress 7:341-362, 1994.
43. Norris FH. Epidemiology of trauma: Frequency and impact of different potentially traumatic events on different demographic groups. J Con Clin Psychol 60:409-418, 1992.

 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
ua31618
Inicio/Home

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008