Distinctiveness of Avoidance and Numbing in PTSD

Abstract

Although the avoidance and numbing symptoms of PTSD are grouped together on the same symptom cluster in DSM-IV-TR, studies of the PTSD symptom structure suggest they are distinct. Studies have validated the distinctiveness of avoidance and numbing by examining their differential correlations with external measures of psychopathology, especially depression. To date, no study has examined the incremental validity of avoidance and numbing with external measures of psychopathology. The current study examined the differential correlations of avoidance and numbing with depression, anxiety, dissociation, and a multi-scale measure of personality functioning in a sample of young adults from Auburn University who reported having experienced a traumatic event. Next, the incremental predictive utility of avoidance and numbing in account for scores on external measures of psychopathology was assessed after controlling for negative self-presentational style. Results replicated previous studies in finding that external measures of psychopathology were correlated more strongly with numbing than with avoidance. Both avoidance and numbing exhibited incremental predictive utility beyond each other and beyond negative self-presentational style, supporting the hypothesis that avoidance and numbing are distinct processes and suggesting that avoidance and numbing should be separated in the DSM-V. Furthermore, the incremental predictive utility of numbing accounted for a greater proportion of the variance than avoidance and also contributed significantly to the prediction of more external correlates than did avoidance. These results emphasize the important role of numbing in PTSD.