Western Michigan University ScholarWorks at WMU Dissertations Graduate College 8-2019 Measuring Contextual Factors Associated with Experiential Avoidance Using a Behavior Analogue Paradigm Meaghan M. Lewis Western Michigan University, meaghan.com Follow this and additional works at: https://scholarworks.edu/dissertations Part of the Clinical Psychology Commons, and the Experimental Analysis of Behavior Commons Recommended Citation Lewis, Meaghan M., "Measuring Contextual Factors Associated with Experiential Avoidance Using a Behavior Analogue Paradigm" (2019).edu/dissertations/3499 This Dissertation-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Dissertations by an authorized administrator of ScholarWorks at WMU. For more information, please contact wmu-scholarworks@wmich.
MEASURING CONTEXTUAL FACTORS ASSOCIATED WITH EXPERIENTIAL AVOIDANCE USING A BEHAVIOR ANALOGUE PARADIGM by Meaghan M. Lewis A dissertation submitted to the Graduate College in partial fulfillment of the requirements for the degree of Doctor of Philosophy Psychology Western Michigan University August 2019 Doctoral Committee: Amy Naugle, Ph., Chair Scott Gaynor, Ph. Tamara Loverich, Ph. Anthony DeFulio, Ph.
Lewis ACKNOWLEGMENTS I wish to start by first acknowledging those who had an important role in my early academic development. Alyce Dickinson whose teaching inspired me to learn and love behaviorism: Thank you for teaching it right and for teaching it well. To my predecessors in the lab whose mentorship helped me to develop critical thinking skills and a love for science. I am extremely grateful for your mentorship and am proud to count you as my friends and colleagues.
I am especially grateful to Drs. Tara Casady, Abby Blankenship, Matthew Jameson, Lauren Borges, Marie Barrett, Ashley Wiedemann, and JooHyun Lee who have continued to provide vertical mentorship to me in invaluable ways. Galen Alessi whom I admire for so many things, but perhaps most for his kindness and his intelligence: I am humbled to have been mentored and supervised by such a wise and thoughtful human. Next to Dr.
Richard Spates whom I had the pleasure to work with in research, teaching, and clinical capacities throughout my training. Also, and perhaps most importantly, I am grateful for the opportunities we had to share stories, comradery, and a love for Hawaii. Scott Gaynor, I thank him for his dedication to teaching and supervision and for his intellectual contributions to this project as a committee member. I also wish to sincerely thank Dr.
Anthony DeFulio who has been a thoughtful critic and whose careful edits, ideas, and suggestions improved this manuscript. To my psychology ohana at the VA Pacific Islands Health Care System who showed me the generosity of the aloha spirit, the value of cohesion and collectivism, and most of all for their good humor that made my internship year perhaps the best ii Acknowledgments – Continued of my life. Shiloh Jordan whose clinical reasoning, snark, and empowering voice I will hear in my head for years to come. Jordan was endlessly there for me this year and I appreciate her more than I can say.
Dennis Perez whose case conceptualization skills are made of gold: I am a more thoughtful clinician and professional because of you. Anthony Giardina for his motivational interviewing expertise that helped me to realize my passion for substance abuse treatment. And to Dr. Michael Mahoney for melding my assessment and differential diagnosis skills and for the opportunities to travel throughout the Pacific Ocean to study rural culture.
I am also extremely thankful to Dr. Maggi Mackintosh for her clinical research support and the opportunity to collaborate. For my internship cohort and to Jessie Manlutac who was like an adoptive mother to me. Each one of you were exactly what I needed, and I gained a community that will be in my corner forever.
I consider myself so fortunate to have begun my training with Dr. Tamara Loverich whose commitment to mentorship I will always strive to emulate. It has been a pleasure to have her continued presence as a member of my dissertation committee and I owe much of my conceptual development to her. I thank her for her nurturance, patience, and guidance that helped me to become passionate about this literature.
Most of all, I thank her for helping me to recognize my value and that I belonged in a doctoral program. Next, to my dissertation chair and advisor, Dr. Amy Naugle whose early beliefs in me and steadfast guidance along the way have made all the difference and without whom none of this would be possible. Naugle has always supported my lofty ideas and ambition by allowing me to do the research I care about and reigned me in with her pragmatism when it was necessary.
She cared not just about who I was as iii Acknowledgments – Continued a professional, but as a person; humored my requests for research deadlines with silly consequences and has always been an outspoken advocate on my behalf. Working with each one of these mentors has enriched my life; teaching me not only to be a better consumer and producer of research, but how to be a compassionate clinician and to live in a way that is consistent with my professional and personal values. I am also incredibly thankful to the current members of the lab for their intellectual contributions to this project and to Tabitha DiBacco, Kyra Bebus, Allie Mann, and Maegan Campbell, who managed data collection while I was away. To my many research assistants, Angelene Greene, Audrey Conrad, Catherine Conway, Frank Lewis, Aaron Pike-Inman, Meghan Llewellyn, Sydney Loranger, Cristal Cardoso Sao Mateus, Humza Rahman, Karissa Scholten, Abbie Tarvis, Sydney Tasker, Jake Tipton, Callum Smith, Hannah Reicherts, and Tray Watson.
I had a blast running participants with all of you and none of this would be possible without your hard work. Next and in no special order, to the friendship and support throughout the years from Brianna Forbis, Dana Goetz, Olivia Gratz, Anita Li, Kirstin Davis, Arsh Kaur, Kristin Koller, and Margo Uwayo without whom I would surely be much lonelier. I wish to sincerely thank my family, especially my mother and father, who never stopped believing in and cheering for me and my Aunt Beth who edited many of my papers along the way. Sabry and Yvonne Gabriel who loved me like I was their daughter.
Finally, I wish to thank my husband Andrew Gabriel who never stops giving. First, for engineering and creating the cold pressor apparatus used in this study and for sacrificing so much to make our life together work. Life in graduate school and being 5,000 miles apart this year have been difficult, but I iv Acknowledgments – Continued never felt his love or support waiver. I cannot imagine my life without Andrew.
Mahalo to everyone and I will be eternally in your debt. Lewis v MEASURING CONTEXTUAL FACTORS ASSOCIATED WITH EXPERIENTIAL AVOIDANCE USING A BEHAVIOR ANALOGUE PARADIGM Meaghan M. Western Michigan University, 2019 The purpose of the present study was to investigate the relationship between levels of state and trait experiential avoidance across two different contexts using behavior analogue methodology. Performance on the cold pressor task (threshold, tolerance, endurance, and intensity; Zettle et al., 2012) was compared to performance on a modified version of the Trier Social Stress Test (TSST; Kirschbaum et al., 1993) to obtain a behavioral measure of experiential avoidance that was standardized across these four behavioral indices.
Data were collected from a convenience sample of undergraduate students (N = 133) from college classrooms on the campus of Western Michigan University. Participants completed the cold pressor task and TSST in a counterbalanced order. Trait and state-based measures of experiential avoidance, emotion dysregulation, positive and negative affect intensity, state and trait anxiety, interpersonal sensitivity, perceived pain tolerance, and fear of negative evaluations were measured at baseline along with average and maximum heart rate. State-based measures were completed again following each task and heart rate data were collected during five minutes of speech preparation as well as directly following the speech, arithmetic, and cold pressor task.
It was hypothesized that participants who reported higher levels of trait experiential avoidance would report decreased threshold, tolerance, and endurance as well as increased intensity of physical and social discomfort across the two behavioral measures, providing evidence that experiential avoidance can be conceptualized as a functional response class. These hypotheses were partially confirmed as high trait experiential avoiders rated the cold pressor task, speech, and arithmetic task as more intense than low trait avoiders. Those higher in trait experiential avoidance also tolerated the speech significantly less longer than those reporting lower levels of trait experiential avoidance. Trait experiential avoidance was also a predictor of positive affect intensity following both the cold pressor task and TSST and of state experiential avoidance post-TSST.
Based on the results of an experimental manipulation check, participants in this study experienced significant increases in state experiential avoidance and reductions in positive affect intensity following each task. State anxiety increased from baseline to post-TSST. Decreased endurance of each task was predictive of greater state experiential avoidance and reductions in positive affect within each task. Fear of negative evaluations and lower arithmetic task endurance were the best predictors of state experiential avoidance following the TSST.
Lower endurance levels were also the best predictor of state experiential avoidance following the cold pressor task, but contrary to hypotheses this did not hold for the TSST. It was also found that state anxiety and fear of negative evaluations were the strongest predictors of state anxiety following the TSST above and beyond self-report and behavioral measures of experiential avoidance. In contrast with hypotheses, performance on the cold pressor task was not a significant predictor of performance on the TSST. However, speech task endurance and state experiential avoidance were the strongest predictors of arithmetic task endurance.
The results of this study support the notion that context is an important factor in understanding experiential avoidance and the strategies used to manage discomfort in the moment following physical and social discomfort are multifaceted. Conceptualization of the function of experiential avoidance in different contexts as well as context-specific treatment implications are discussed. TABLE OF CONTENTS ACKNOWLEDGMENTS .ii LIST OF TABLES. 1 Overview of the Present Study.
1 Self-Report Measures in Behavioral Sciences. 5 Event or Construct?. 5 Transdiagnostic Models of Psychopathology and Experiential Avoidance. 10 Correlates of Experiential Avoidance.
13 Self-Report Measures of Experiential Avoidance. 15 Behavioral and Physiological Measures of Experiential Avoidance. 17 Physically Aversive Stimuli. 19 Feedback, Social Stress, and Avoidance.
21 Study Rationale and Hypotheses. 24 Cold Pressor Task Hypotheses. 24 Trier Social Stress Test Hypotheses. 27 Self-Report Hypotheses.
30 vi Table of Contents—Continued METHOD. 33 Scheduling and Informed Consent. 33 Heart Rate Measurement. 33 Self- Report Measures.
34 Acceptance and Action Questionnaire-II. 34 Multidimensional Experiential Avoidance Questionnaire. 35 State Measure of Experiential Avoidance. 35 State Difficulties in Emotion Regulation Scale.
36 State-Trait Anxiety Inventory. 36 Positive and Negative Affect Schedule. 37 Brief Fear of Negative Evaluation Scale. 37 Brief Symptom Inventory.
38 Social Desirability Scale-17. 39 Cold Pressor Task. 39 Trier Social Stress Test. 41 vii Table of Contents—Continued Design.
48 Treatment of Missing Data. 48 Normality, Linearity, and Homoscedasticity. 52 Cold Pressor Task Hypotheses. 53 Trier Social Stress Test Hypotheses.
54 Self-Report Hypotheses. 56 Trait Experiential Avoidance Measures. 57 State Experiential Avoidance Measures. 59 Experimental Manipulation Check.
61 Paired Samples t-tests for Cold Pressor Task. 61 Paired Samples t-tests for TSST. 64 Cold Pressor Task Analyses. 64 Trier Social Stress Test Analyses.
67 Task Comparison Analyses. 70 Hierarchical Linear Regression Analyses Comparing Task Performance. 72 viii Table of Contents—Continued DISCUSSION. 74 Limitations and Future Directions.
Human Subjects Institutional Review Board Full Approval Letter. Informed Consent Document. Heart Rate Monitor Visual Instructions. Cold Pressor Task Experimenter Instructions.
TSST Experimenter Instructions. Figure Depicting the Cold Pressor Apparatus .