Emotional Avoidance Research Articles

Comprehensive Review: Exploring the Impact of Physiotherapy on Post-Traumatic Stress Disorder (PTSD)

PTSD is a severe mental health disorder that is found in millions of people across the world and develops from psychological signs that include flashbacks, hyperarousal, and emotional avoidance. However, there is still evidence that PTSD is not limited to the mental health area only and might have a vast effect on physical health, too. In the past, clients with psychosis largely received medication and some form of cognitive/behavioral talk therapy like CBT. It has been in the recent past that literature investigating the part of physiotherapy in PTSD treatment has commenced, whereby they supply therapeutic approaches aimed at handling the mental and physical effects of trauma. Exercise therapy, breathing exercises, and mind-body interventions, including yoga and tai chi, greatly reduce the symptoms of PTSD based on physiotherapy. The purpose of this review is to examine the place of physiotherapy in the treatment of PTSD, discuss the existing literature supporting this profession's application, and explain practical ways physiotherapy may be incorporated into the general, evidence-based PTSD treatment plan.PTSD,

An Examination of the Relationship between Family Climate, Emotional Authenticity, and Technology Addiction among University Students

This study aims to examine the relationships between family climate, emotional authenticity, and technology addiction among university students. The research was conducted with 1,012 university students, based on a descriptive-relational survey model. Data were collected using family climate, emotional authenticity, and technology addiction scales, and analyzed through descriptive analysis, t-tests, ANOVA, Pearson correlation, and multiple linear regression analysis. The results indicate that participants generally have a positive family climate. In terms of emotional authenticity, it was found that students have a moderate ability to express their emotions and understand the emotions of others. The levels of technology addiction were also found to be generally moderate. The model used in the study revealed that the independent variables explained 35.6% of the variance in technology addiction. It was found that as family relationality (β=-0.18), cognitive harmony (β=-0.07), acceptance of external influence (β=-0.17), and emotional avoidance (β=-0.37) increased, technology addiction decreased, while an increase in intergenerational authority (β=0.17) led to an increase in technology addiction. These findings highlight the impact of family relationships and individuals' emotional experiences on technology addiction. Furthermore, it was found that family climate, emotional authenticity, and technology addiction scores significantly differed according to gender and class level. These findings contribute to the understanding of important socio-psychological factors affecting technology addiction among university students.

DELINEATING TOXIC MASCULINITY IN TANA FRENCH’S THE WITCH ELM

This article explores the concept of toxic masculinity in The Witch Elm (2018), a novel by Tana French, using R.W. Connell's theory of hegemonic masculinity and Amy Wharton's sociology of gender frameworks. The research focuses on the protagonist, Toby, who shows toxic masculine traits such as emotional suppression, independence, aggression, and vulnerability avoidance. The study uses qualitative descriptive analysis, examining key scenes in the novel in which these behaviors manifest, especially in relation to family and romantic partners. Through this analysis, the findings reveal how toxic masculinity not only contributes to Toby's deteriorating mental health but also isolates him emotionally, resulting in damaged relationships and increased psychological distress. Ultimately, the article concludes that toxic masculinity extends emotional isolation, reinforcing harmful gender norms that prevent men from seeking support or expressing vulnerability. The research contributes to a broader discourse on how societal expectations of masculinity negatively impact individual males while continuing gender inequality. The study highlights the importance of challenging these norms to foster healthier emotional expression, stronger relationships, and more fair gender dynamics in society.

Between Can’t and Won’t: The Relationship Between Trait Mindfulness, Stoic Ideology, and Alexithymia in Norway and New Zealand

Abstract Objectives The aim of the present study was to provide cross-cultural insight into the relationship between mindfulness, alexithymia, and stoic ideology. Method Using samples from New Zealand (n = 330) and Norway (n = 326), we estimated the facet-level network relationship of our target constructs, as well as the invariance of the estimated networks across cultural contexts. Results Across cultural contexts, we found a consistent pattern of relationships in which both stoic ideology and alexithymia were negatively related to mindfulness. Negative relationships were especially pronounced between alexithymia and the mindfulness facets of Describing, Non-Judgement, and Acting with Awareness. This indicates that individual differences in these mindfulness facets might be more firmly rooted in difficulties identifying and describing emotions, compared to beliefs related to emotional suppression, as captured by stoic ideology. While the mindfulness facets showed overall expected patterns of relationships with both alexithymia and stoic ideology, Non-Reacting showed a divergent pattern. Non-Reacting was positively related to a tendency of Externally Oriented Thinking, as well as with Death-Acceptance, in both countries. Thus, this facet not only might capture Non-reactivity within the context of mindfulness, but also could potentially capture aspects of emotional avoidance. Conclusions Overall, the study highlights that mindfulness could be influenced by both individual differences in emotion processing and cognitive beliefs about emotion processing. This accentuates the importance of examining both individual differences in, and cognitive beliefs about emotion regulation in research regarding mindfulness.

Psychometric Properties of the Persian version of the Heidelberg Form for Emotion Regulation Strategies (HFERST)

Background and Objectives: This study aims to measure the psychometric properties of the Persian version of the Heidelberg form for emotion regulation strategies (HFERST). Methods: In this study conducted from November to December 2022, participants were 333 people aged 18-60 years in Iran who were selected by a convenience sampling method. To evaluate the convergent and divergent validity of the Persian HFERST, the acceptance and action questionnaire-second edition, the difficulty in emotion regulation scale, and the depression, anxiety and stress scale were used. Reliability was assessed using Cronbach’s alpha and test-retest method. The data analysis was done in SPSSsoftware, version 25 and LISREL version 8.8. Results: The results of confirmatory factor analysis confirmed the 8-factor solution of the questionnaire. The Cronbach’s alpha coefficient for the subscales of rumination, reappraisal, acceptance, problem solving, suppression of emotional expression, suppression of emotional experiences, avoidance and social support were 0.88, 0.87, 0.90, 0.91, 0.84, 0.89, 0.92, and 0.90, respectively. In addition, the four-week test-retest reliability for the mentioned subscales were 0.83, 0.80, 0.85, 0.89, 0.80, 0.82, 0.86, and 0.91, respectively. Conclusion: The Persian HFERST is a reliable and valid scale for measuring emotion regulation strategies in Iranian samples.

Mapping a psychosocial syndemic among methamphetamine-using sexual minority men living with HIV.

While research with sexual minority men (SMM) has focused on disparities related to HIV, substance use and mental health, synergistic psychosocial pathways driving these epidemics remain underexplored. We used syndemic theory to assess how psychosocial factors sustain methamphetamine use and hinder recovery efforts for SMM living with HIV. A triangulation of network analyses and constructivist grounded theory approaches is utilised to elucidate pathways through which psychosocial factors influence methamphetamine use among this population. Survey data (N = 129) are used for quantitative analyses and a purposive sub-sample (n = 24) was recruited for semi-structured interviews for qualitative analyses. The network analysis revealed two statistically significant bivariate associations: between post-traumatic stress disorder and depression symptoms (b = 0.37, SD = 0.07, 95% confidence interval [0.23, 0.49]) and between depression symptoms and negative affect (b = 0.26, SD = 0.07, 95% confidence interval [0.12, 0.38]). Findings from the constructivist grounded theory analysis supplement the network analysis by offering a nuanced take on how negative affect, post-traumatic stress disorder, and depression symptoms operate synergistically to promote methamphetamine use and impede recovery efforts. Participants relay experiences of using methamphetamine to cope with these psychosocial factors through avoidance, escapism, mood elevation, and numbing of emotions. Findings suggest that centring these psychosocial factors may inform more effective, holistic interventions for this high-priority population.

Treatment as a moderator and executive function as a mediator of the effect of a mindfulness ecological momentary intervention for generalized anxiety disorder.

Theory and research indicated that executive functioning (EF) correlated with, preceded, and stemmed from worry in generalized anxiety disorder (GAD). The present secondary analysis (Zainal & Newman, 2023b) thus determined whether EF domains mediated the effect of a 14-day (5 prompts/day) mindfulness ecological momentary intervention (MEMI) against a self-monitoring control (SM) for GAD. Participants (N = 110) diagnosed with GAD completed self-reported (Attentional Control Scale, GAD Questionnaire, Perseverative Cognitions Questionnaire) and performance-based tests (Letter-Number Sequencing, Stroop, Trail Making Test-B, Verbal Fluency) at baseline, post-treatment, and one-month follow-up (1MFU). Causal mediation analyses determined if pre-post changes in EF domains preceded and mediated the effect of MEMI against SM on pre-1MFU changes in GAD severity and trait repetitive negative thinking (RNT). MEMI was more efficacious than SM in improving pre-post inhibition (β = -2.075, 95% [-3.388, -0.762], p = .002), working memory (β = 0.512, 95% [0.012, 1.011], p = .045), and set-shifting (β = -2.916, 95% [-5.142, -0.691], p = .010) but not verbal fluency and attentional control. Within groups, MEMI but not SM produced improvements in all examined pre-post EF outcomes except attentional control. Only pre-post improvements in inhibition mediated the effect of MEMI against SM on pre-1MFU reductions in GAD severity (β = -0.605, 95% [-1.357, -0.044], p = .030; proportion mediated = 7.1%) and trait RNT (β = -0.024, 95% [-0.054, -0.001], p = .040; proportion mediated = 7.4%). These patterns remained after conducting sensitivity analyses with non-linear mediator-outcome relations. Optimizing MEMI for GAD might entail specifically boosting inhibition plausibly by augmenting it with dialectical behavioral therapy, encouraging high-intensity physical exercises, and targeting negative emotional contrast avoidance.

Identificación de Indicadores de TEPT y su Relación con el Sexo y las Estrategias de Afrontamiento en Estudiantes de Psicología

Abstract Coping strategies play a role in protecting well-being, which is why the presence of indicators of Post-Traumatic Stress Disorder (PTSD) and the use of coping strategies were identified in psychology students. The study follows a non-experimental cross-sectional observational design with intentional, non-probabilistic quota sampling, involving 60 psychology students. 40% of the evaluated population presents PTSD, and the coping styles employed most frequently are religion, emotional avoidance, aggressive reaction, and social support. No significant relationship is found between PTSD diagnosis and the variables of gender and coping style. It is concluded that student gender and coping style do not exhibit an association with PTSD diagnosis.

A meta-analysis of coping strategies and psychological distress in rheumatoid arthritis.

Theory and research indicate that coping plays a central role in the experience of psychological distress in people with rheumatoid arthritis (RA). This study meta-analysed the associations of adaptive and maladaptive coping strategies with psychological distress in people with RA to quantify and better understand the proposed differential relationships, as well as the factors that might influence these links. Searches of four databases identified eligible studies according to a pre-registered protocol. Two random effects meta-analyses examined the direction and magnitude of the links between adaptive coping (problem-focused and emotional approach coping) and maladaptive coping (emotional avoidance and pre-occupation coping) and psychological distress (stress, anxiety, and depression). Study quality was evaluated using a bespoke tool. Moderator analyses for sample characteristics and distress type were conducted. Searches identified 16 eligible studies with 46 effects. Meta-analysis of maladaptive coping and distress yielded a significant, medium sized association, k = 12, r = .347, 95% CIs [.23, .46]. Moderator analyses were significant only for type of distress, with effects for depression being larger than that for combined distress. Effects did not vary as a function of age, participant sex, or disease duration. Meta-analysis for adaptive coping was not significant, k = 10, r = -.155, 95% CIs [-.31, .01]. Findings from this first meta-analysis of coping and distress in RA indicate that maladaptive but not adaptive coping is associated with greater distress. Further research is needed to grow the evidence base to verify the current findings especially with respect to adaptive coping.

The role of emotion in urban development decision-making: A qualitative exploration of the perspectives of decision-makers

People's feelings about their neighbourhoods are important for health, but they may be undervalued in urban development decision-making. This study explores how decision-makers understand and respond to residents' emotions. Reflexive thematic analysis was conducted on a secondary dataset consisting of 123 interviews with influential professionals in urban development decision-making. We developed three themes and one subtheme: ‘(mis)understanding residents’ emotions', ‘neglecting the health impact of positive emotions’, ‘avoidance of emotion in community engagement’ and ‘sanitized emotions’. We recommend decision-makers engage directly with residents' emotions during urban development processes to ensure healthier place-making.

Associations between Dental Anxiety Levels, Self-Reported Oral Health, Previous Unpleasant Dental Experiences, and Behavioural Reactions in Dental Settings: An Adult E-Survey.

Background and Objectives: The aim of this study was to investigate the prevalence of dental anxiety, its association with self-reported oral health, and sociodemographic factors in adults that are critical for improving oral health and well-being. Materials and Methods: An online survey was conducted via social media, with 1551 adults (76.5% women, 23.5% men) participating nationwide. Data collected included demographic data, Modified Dental Anxiety Scale (MDAS) scores, and associations between dental anxiety, negative experiences, and self-reported oral health. The analysis included psychophysiological, behavioural, and emotional responses and avoidance of dental visits, using descriptive and generalised linear regression models. Results: This study found that the mean score of the MDAS was 9.70 ± 5.11 out of 25, 19.1% of the participants reported no dental anxiety, and 7.8% suffered from dental phobia. Gender, age, and socioeconomic status had no significant effect on the prevalence of anxiety. Although more than half of the participants reported negative dental experiences, particularly in childhood, anxiety levels were unaffected. However, those who rated their oral health as excellent or very good had lower anxiety scores (p = 0.008, p = 0.024). Among the dental procedures, oral surgery (58.7%) and prosthetic (restorative) dental treatments (15.2%) caused the most anxiety. Avoidance behaviour correlated with increased anxiety (p ≤ 0.001), as did postponing dental visits until severe pain occurred (p = 0.011). Conclusions: These results emphasise the significant prevalence of dental anxiety in adults, particularly for surgical procedures and drilling, posing challenges in patient management. Tailored strategies are essential to reduce anxiety, improve patient well-being, and optimise dental service delivery and treatment efficacy.

Personality disorders and their association with adverse childhood events.

Theoretical models of personality disorders (PDs) highlight the role of adverse childhood experiences (ACEs) in the development and maintenance of personality pathology. This review presents recent studies on the associations between childhood adversity and PDs, while discussing mechanisms and factors that impact these relationships. Studies point to small to moderate associations between childhood adversity and cluster A, cluster B and cluster C PDs, and some research suggests that childhood adversity could be a predictor for the onset and development of personality pathology. Most research focuses on borderline PD, while research on other PDs is limited. Some mechanisms that explain these associations have been proposed, with the literature investigating emotion dysregulation, dissociation, avoidance or psychosocial dysfunction as mediators. The consistent associations between ACEs and PDs seems to point that childhood adversity could be a transdiagnostic risk factor for PDs, but research warrants further prospective investigations for causal conclusions, and calls for future research to investigate potential mediators and moderators more thoroughly.

Mapping Emotion Regulation Patterns Within the Alternative Model of Personality Disorders Personality Traits.

Personality pathology is associated with emotional problems that are potentially attributable to problematic emotion regulation strategy patterns. We evaluated the emotion regulation strategies associated with the pathological personality traits in the Alternative Model of Personality Disorders (AMPD). A total of 504 participants completed measures of AMPD traits and strategy usage, which were analyzed using hierarchical regressions and latent profile analysis (LPA). Regression results demonstrated that each trait was associated with a unique strategy pattern: negative affect with emotional overengagement, detachment with socialemotional avoidance, antagonism with emotional externalization/avoidance, disinhibition with emotional avoidance and overengagement, and psychoticism with strategies linked to psychotic/dissociative experiences. The LPA identified three profiles with heightened AMPD traits: an internalizing/distressed profile, an externalizing/distressed profile, and a schizoid-schizotypal profile; each had a unique strategy pattern that varied depending on trait composition. This research highlights the relevance of emotion regulation strategy patterns in the assessment, conceptualization, and treatment of personality pathology.

Uncovering the most robust predictors of problematic pornography use: A large-scale machine learning study across 16 countries.

Problematic pornography use (PPU) is the most common manifestation of the newly introduced compulsive sexual behavior disorder diagnosis in the 11th revision of the International Classification of Diseases. Research related to PPU has proliferated in the past two decades, but most prior studies were characterized by several shortcomings (e.g., using homogenous, small samples), resulting in crucial knowledge gaps and a limited understanding concerning empirically based risk factors for PPU. This study aimed to identify the most robust risk factors for PPU using a preregistered study design. Independent laboratories' 74 preexisting self-report data sets (Nparticipants = 112,397; Ncountries = 16) were combined to identify which factors can best predict PPU using an artificial intelligence-based method (i.e., machine learning). We conducted random forest models on each data set to examine how different sociodemographic, psychological, and other characteristics predict PPU, and combined the results of all data sets using random-effects meta-analysis with meta-analytic moderators (e.g., community vs. treatment-seeking samples). Predictors explained 45.84% of the variance in PPU scores. Out of the 700+ potential predictors, 17 variables emerged as significant predictors across data sets, with the top five being (a) pornography use frequency, (b) emotional avoidance pornography use motivation, (c) stress reduction pornography use motivation, (d) moral incongruence toward pornography use, and (e) sexual shame. This study is the largest and most integrative data analytic effort in the field to date. Findings contribute to a better understanding of PPU's etiology and may provide deeper insights for developing more efficient, cost-effective, empirically based directions for future research as well as prevention and intervention programs targeting PPU. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Study on Short Video Infomercial Avoidance Factors Based on the Perspective of Flow - Taking Tiktok App as an Example

Short video has become a national application at the same time, short video information flow advertising avoidance also continues to appear. Few studies have looked at the avoidance behavior of short video information streams from the perspective of psychological theory and social theory. Taking Tiktok APP as an example and combining the characteristics of short video information stream advertising, this study constructed a model of influencing factors of information stream advertising avoidance from the perspective of flow. In this paper, 220 samples were analyzed by questionnaire survey, and it was found that the scene adaptation of Tiktok information flow advertisements negatively affected the cognitive avoidance and emotional avoidance behaviors of advertisements through the flow state. The push accuracy of Tiktok Yin information flow advertisement negatively affects the cognitive avoidance, emotional avoidance and behavioral avoidance of advertisement through the flow state. The study of advertising avoidance behavior from the perspective of flow has enriched the theoretical perspective of the study of advertising avoidance in short video information flow, and also provided theoretical and practical suggestions for advertisers in short video advertising.

Homophobic beliefs and attitudes among mid-adolescent boys: exploring the ideas of hybrid masculinities.

Homophobia is well-documented as key to social regulation of masculine behavior and practices in Western settings. Yet, empirical data from a number of Western settings has shown a decline in overt homophobic attitudes in the past decade, leading some to suggest that the nature of masculinities is also changing. However, theorizing on the changing nature of masculinities among adolescents has received limited quantitative attention. Research is needed to better understand shifts in adolescent masculinities in contemporary Western settings. In this paper, we investigate the application of one newer approach to explore masculinities in context - hybrid masculinities - in a sample of cisgender, heterosexual, mid-adolescent boys in one province in Western Canada (N = 873, mean age (SD) = 14.39 (0.37)). Data were collected from nine cohorts of grade 9 youth over a 10-year period (2013-2022) as part of the baseline survey of an ongoing evaluation of a gender-transformative healthy relationships program. We hypothesized that if the ideas of hybrid masculinities held in our sample, we would find that overt homophobic attitudes and adherence to related patriarchal norms (e.g., avoidance of femininity) would decline over this period, but that the use of homophobic name-calling would remain differentiated in terms of to whom it was directed (e.g., a friend, someone they thought was gay). We did find a significant decline in homophobic attitudes and norms related to emotional restriction and avoidance of femininity over the 10-year period, but also found that homophobic name-calling remained differentiated, with significantly higher name-calling toward a friend than toward someone the youth thought was gay. Thus, our hypotheses were supported. We discuss the implications of our findings for future theory and research on understanding adolescent masculinities in context.

Psychological intervention in women victims of childhood sexual abuse: a randomized controlled clinical trial comparing EMDR psychotherapy and trauma-focused cognitive behavioral therapy.

Childhood sexual abuse persists as a painful societal reality, necessitating responses from institutions and healthcare professionals to prevent and address its severe long-term consequences in victims. This study implements an intervention comprising two psychotherapeutic approaches recommended by the WHO and international clinical guidelines for addressing short-, medium-, and long-term posttraumatic symptomatology: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Both approaches are adapted from group formats for implementation in small online groups via Zoom. The impact of both therapeutic approaches on trauma improvement was assessed in a sample of 19 women who were victims of childhood sexual abuse through a Randomized Clinical Trial comparing EMDR Psychotherapy and Trauma-Focused Cognitive Behavioral Therapy after a baseline period. Intra and inter comparison were made using statistics appropriate to the sample. Both therapeutic approaches significantly reduced symptomatology across various evaluated variables, suggesting their efficacy in improving the quality of life for these individuals. Following CBT-FT treatment, patients exhibited enhanced emotional regulation, reduced reexperiencing, and avoidance. The EMDR group, utilizing the G-TEP group protocol, significantly improved dissociation, along with other crucial clinical variables and the perception of quality of life. Although the limitations of this study must be taken into account due to the size of the sample and the lack of long-term follow-up, the results align with existing scientific literature, underscoring the benefits of trauma-focused psychological treatments. The online group format appears promising for enhancing the accessibility of psychological treatment for these women. Furthermore, the differential outcomes of each treatment support recent research advocating for the inclusion of both approaches for individuals with trauma-related symptomatology. The study has been approved by the Ethics Committee of the Valencian International University (VIU) (Valencia, Spain) (Ref. CEID2021_07). The results will be submitted for publication in peer-reviewed journals and disseminated to the scientific community. https://clinicaltrials.gov/ct2/show/NCT04813224, identifier NCT04813224.

"Finding my voice again" - women's experiences of psychological therapy in perinatal secondary care settings: a qualitative study.

Although women often experience mental health comorbidities in the perinatal period, the evidence-base for psychological therapy across diagnostic boundaries in the perinatal period remains limited. As there is a need to understand experiences of therapy, irrespective of diagnosis, to inform intervention provision, the aims of this study were to explore women's experiences of psychological therapy for perinatal mental health difficulties and to identify the mechanisms that women attributed to the most significant therapeutic change for themselves and/or the mother-infant relationship. Semi-structured interviews were conducted with 16 women who received therapy within specialist perinatal community mental health settings in the Northwest of England, the UK. Interview data were analysed using reflexive thematic analysis. One overarching theme entitled participant life stories were at the heart of therapy was identified alongside three other main themes: 1.) We're in this together - therapeutic bond and establishing a coherent sense of self, 2.) Surfing the urge to 'fix' feelings - Sitting with emotions improved regulation and 3.) Seeing myself in a new light - Shifting self-blame to self-compassion enhanced self-efficacy. Theme 1 consisted of three subthemes. Participants described the quality of the therapeutic relationship as the fundamental foundation to (re)connecting with their needs, values and boundaries, which improved their sense of agency, self-esteem, therapeutic engagement and self-understanding. Shifting emotional avoidance to emotional engagement improved their self-regulation. Considering alternative factors that could have contributed to their experiences helped them to defuse self-blame and enhance self-compassion. Finally, changes in their mental health led to positive relational changes in their relationship with their infant and improved communication with partners. Sensitivity, engagement and responsivity experienced in the therapist-woman relationship was reported to be mirrored in the mother-infant relationship. Developing a coherent sense of self and self-regulation skills both appeared to heighten women's self-compassion and empathy for their infants, which also seemed to improve their ability to tolerate uncertainty and mixed emotions within themselves and their infants. The mechanisms of change in the perinatal period are important to consider at a stakeholder, therapist and service management level to parsimoniously and best meet the needs of women and the mother-infant relationship.

Personality and Pain Outcomes in Rheumatic Disease: The Mediating Role of Psychological Flexibility.

Chronic pain is associated with increased disability and vulnerability to emotional disorders. Personality and psychological flexibility (PF) describe interindividual differences that shape the adjustment to chronic pain. Specifically, PF was found to be associated with pain, fatigue, anxiety, and depression intensity. Although previous studies established strong correlations between personality and pain outcomes, evidence on the nature of this relationship is scarce. Therefore, the objective of this study is to explore the mediating effect of PF on the relationship between personality and distress. This transversal study included 108 participants (age M = 56.7, SD = 11.3) diagnosed with musculoskeletal chronic pain. Self-reported measures were administered by the medical care team. Multiple mediation models were performed for estimating the indirect effects on each outcome variable. After controlling for age and gender covariates, we found that PF completely mediated the relationship between personality traits and all pain outcomes and partially mediated the impact of extraversion on anxiety. In addition, emotional stability also had an indirect effect on anxiety through PF. Personality traits and PF are significant predictors of pain outcomes. PF represents a core process mediating the impact of personality traits on the perceived intensity of pain, fatigue, anxiety, and depression in patients with rheumatic disease. These results could facilitate the application of individualized psychological interventions in clinical contexts targeting the reduction of emotional avoidance and in chronic pain patients.

Exploring Emotional Dysregulation and Avoidance with Caregivers as the Mechanisms Linking Social Communication Understanding and Aggressive Behaviours.

Many autistic adolescents and young adults present with aggressive behaviours, which can be challenging for caregivers. The present study aimed to explore the underlying mechanisms between social communication understanding and aggressive behaviours in autistic and non-autistic adolescents, specifically the role of emotional dysregulation and its impact on avoidance with caregivers. Caregivers of autistic (n=275) and non-autistic adolescents (n=123) completed standardised caregiver-report questionnaires measuring social communication understanding, emotional dysregulation, avoidance between the adolescent and caregiver and aggressive behaviours. A serial mediation analysis indicated that levels of social communication understanding were indirectly associated with aggressive behaviours. This occurred through increased emotional dysregulation, which may have led to increased avoidance between the autistic and non-autistic adolescents and their caregivers. These findings support a sequential process by which adolescents with low social communication understanding are more likely to behave aggressively through being emotionally dysregulated and the impact of this on the increased avoidance within the caregiver-adolescent dyad. This process was found within autistic and non-autistic adolescents, suggesting a mechanism across individuals with aggression. These findings indicate that interventions based on improving emotion regulation ability and responses between adolescents and their caregivers may aid in reducing aggressive behaviours in adolescents and young adults with lower social communication understanding.