A longitudinal test of the bi-directional relations between avoidance coping and PTSD severity during and after PTSD treatment

Christal L. Badour, Daniel M. Blonigen, Matthew Tyler Boden, Matthew T. Feldner, Marcel O. Bonn-Miller

Research output: Contribution to journalArticlepeer-review

82 Scopus citations


Avoidance coping and symptoms of posttraumatic stress disorder (PTSD) covary. However, relatively little research has examined the bi-directional relation between these constructs among individuals in treatment for PTSD. The current longitudinal study examined the reciprocal associations between avoidance coping and PTSD symptom severity during and after residential PTSD treatment among a sample of 1073 military veterans (88.9% male; Mage = 52.39 years) with chronic, treatment-resistant PTSD. Greater avoidance coping at intake predicted more severe PTSD symptoms at discharge, and severity of PTSD symptoms at discharge predicted increased avoidance at follow-up. Conversely, PTSD symptom severity at intake was not related to avoidance coping at discharge, and in turn avoidance coping at discharge was not related to PTSD symptom severity at follow-up. These findings offer a number of important clinical implications including evidence suggesting avoidance may predict poorer treatment response among individuals seeking treatment for chronic PTSD, and that greater end-of-treatment PTSD symptom severity may predict increased avoidance following treatment.

Original languageEnglish
Pages (from-to)610-616
Number of pages7
JournalBehaviour Research and Therapy
Issue number10
StatePublished - Oct 2012

Bibliographical note

Funding Information:
This work was supported, in part, by the following: A VA Clinical Science Research and Development (CSR&D) Career Development Award – 2 (Bonn-Miller) and a VA HSR&D SUD-QUERI grant ( RRP 10-192 ; Bonn-Miller). Christal L. Badour was supported by a NIMH National Research Service Award (F31 MH092994-01). Daniel M. Blonigen was supported by a Career Development Award – 2 from the VA office of Research and Development (Clinical Sciences Research & Development). The expressed views do not necessarily represent those of the Department of Veterans Affairs. The authors would like to thank Dr. Kent D. Drescher at the National Center for PTSD at the VA Palo Alto Health Care System for collecting and providing access to the data.


  • Avoidance
  • PTSD
  • Posttraumatic stress
  • Treatment

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Clinical Psychology
  • Psychiatry and Mental health


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