Emotional Nonacceptance, Distraction Coping and PTSD Symptoms in a Trauma-Exposed Adolescent Inpatient Sample

  • Emma C. Woodward
  • Andres G. VianaEmail author
  • Erika S. Trent
  • Elizabeth M. Raines
  • Michael J. Zvolensky
  • Eric A. Storch
Original Article


Emotional nonacceptance is associated with greater posttraumatic stress disorder (PTSD) symptoms among trauma-exposed youth. Similarly, the use of distraction as a coping strategy is associated with greater PTSD symptoms, yet synergistic relations between emotional nonacceptance and distraction coping among trauma-exposed youth have not been examined. The present study examined associations and interactive effects of emotional nonacceptance and distraction coping in relation to PTSD symptoms among trauma-exposed inpatient adolescents. Participants included 50 adolescents (52.0% female; Mage = 15.1 years, SD = .51; 44% White) receiving acute psychiatric care at an inpatient hospital. All participants reported experiencing at least one traumatic event and completed measures of emotion dysregulation, coping strategies, and PTSD symptoms. Analyses revealed a significant interaction between emotional nonacceptance and distraction coping in relation to PTSD symptoms (∆R2 = 0.05; B = 0.60, SE = 0.29; t = 2.06, p = 0.045; 95% CI [0.12, 1.18]). PTSD symptoms were most severe among youth who reported higher levels of emotional nonacceptance and greater use of distraction as a coping strategy. Difficulties accepting negative emotions, coupled with greater use of distraction as a coping mechanism, were associated with more severe PTSD symptoms. The importance of teaching adaptive coping mechanisms to trauma-exposed youth who experience difficulties accepting negative emotions is discussed.


Emotion regulation Coping Trauma PTSD Children Adolescents 


Compliance with Ethical Standards

Conflicts of interest

Dr. Eric Storch has received funding from the National Institute of Health, Red Cross, the Rebuild Texas Fund, and the Texas Higher Education Coordinating Board, and book royalties from Elsevier, Wiley, Springer, Oxford University Press, and the American Psychological Association, and has consulted for Levo Therapeutics. The remaining authors declare no conflicts of interest.

Research Involving Human Participants and/or Animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Emma C. Woodward
    • 1
  • Andres G. Viana
    • 1
    • 2
    • 5
    Email author
  • Erika S. Trent
    • 1
  • Elizabeth M. Raines
    • 1
  • Michael J. Zvolensky
    • 1
    • 3
  • Eric A. Storch
    • 4
  1. 1.Department of PsychologyUniversity of HoustonHoustonUSA
  2. 2.Texas Institute of Measurement, Evaluation, and StatisticsUniversity of HoustonHoustonUSA
  3. 3.Department of Behavioral ScienceThe University of Texas MD Anderson Cancer CenterHoustonUSA
  4. 4.Menninger Department of Psychiatry & Behavioral SciencesBaylor College of MedicineHoustonUSA
  5. 5.Child Temperament, Thoughts, and Emotions Laboratory, Department of PsychologyUniversity of HoustonHoustonUSA

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