Traumatic stress, affect dysregulation, and dysfunctional avoidance: a structural equation model.

The multivariate relationship between interpersonal trauma, posttraumatic stress, affect dysregulation, and various avoidance behaviors was examined in a sample of 418 trauma-exposed participants from the general population. Structural equation modeling indicated that (a) suicidality, substance abuse, dissociation, and problematic activities such as self-injury and dysfunctional sexual behaviors were all indicators of a robust latent variable, named dysfunctional avoidance, (b) accumulated exposure to various types of interpersonal trauma was associated with this avoidance factor, and (c) the relationship between trauma and dysfunctional avoidance was independently mediated by both posttraumatic stress and diminished affect regulation capacity.