Does experiential avoidance explain the relationships between shame, PTSD symptoms, and compulsive sexual behaviour among women in substance use treatment?

Abstract

Untreated compulsive sexual behaviour (CSB) poses a risk to efficacious substance use disorder (SUD) treatment. Yet the ways in which CSB manifests in women with SUDs remains poorly understood. Shame and trauma exposure are well-documented correlates for women's CSB. Prior theory suggested women with shame and trauma-related symptoms may engage in CSB in an effort to escape aversive internal experiences. Thus, the present study examined experiential avoidance as a mediator of the relationship between defectiveness/shame beliefs, post-traumatic stress disorder symptoms, and CSB in a sample of women with SUDs. Cross-sectional, self-report data were collected from 446 women (M age=37.40) in residential treatment for SUDs. Experiential avoidance partially mediated the relationship between both post-traumatic stress disorder symptoms and defectiveness/shame beliefs and CSB. These results extend theoretical conceptualizations of women's CSB to a treatment population. CSB intervention efforts may benefit from targeting women's avoidance of painful experiences.