Child Psychiatry & Human Development

, Volume 49, Issue 1, pp 146–154 | Cite as

Emotional Clarity, Anxiety Sensitivity, and PTSD Symptoms Among Trauma-Exposed Inpatient Adolescents

  • Andres G. Viana
  • Abigail E. Hanna
  • Emma C. Woodward
  • Elizabeth M. Raines
  • Daniel J. Paulus
  • Erin C. Berenz
  • Michael J. Zvolensky
Original Article


Although several investigations—on primarily adult samples—demonstrate a potential role of emotion dysregulation in the etiology and maintenance of posttraumatic stress disorder (PTSD), investigations into the mechanisms that may underlie these associations in general and among adolescents in particular are lacking. The present study examined associations among emotional clarity (i.e., the extent to which individuals are confused about the specific emotions they are experiencing), (Gratz, Journal of Psychopathology Behavioral Assessment 26(1):41–54, 2004) anxiety sensitivity, and DSM-IV PTSD symptom cluster severity (i.e., re-experiencing, avoidance, and hyperarousal symptoms) in a diverse sample of trauma-exposed inpatient adolescents. It was hypothesized that anxiety sensitivity would underlie association between emotional clarity and PTSD symptoms. Participants (N = 50; 52.0% female; Mage = 15.1 years, SD = 0.51; 44% White) completed measures of emotion dysregulation, anxiety sensitivity, and PTSD. Lower emotional clarity was significantly associated with greater total PTSD symptoms, as well as re-experiencing, avoidance, and arousal symptoms. Additionally, there were indirect effects for lack of emotional clarity via anxiety sensitivity in relation to total PTSD symptoms [B = 0.17, SE = 0.08, BC 95% CI (0.04, 0.35)], re-experiencing symptoms [B = 0.15, SE = 0.08, BC 95% CI (0.03, 0.36)], avoidance symptoms [B = 0.12, SE = 0.07, BC 95% CI (0.02, 0.29)], and hyperarousal symptoms [B = 0.17, SE = 0.08, BC 95% CI (0.04, 0.36)]. Reversed models were violated, supporting the direction of hypothesized effects. Difficulties recognizing and accurately understanding emotions may increase risk for PTSD symptoms among trauma-exposed youth. Furthermore, anxiety sensitivity may be a promising intervention target among youth at risk for PTSD, especially among those demonstrating poorer emotional clarity.


Trauma Adolescence Emotion dysregulation Anxiety sensitivity Anxiety 


Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest to declare.

Informed Consent

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

Research Involving Human and Animal Participants

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.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Andres G. Viana
    • 1
  • Abigail E. Hanna
    • 1
  • Emma C. Woodward
    • 1
  • Elizabeth M. Raines
    • 1
  • Daniel J. Paulus
    • 1
  • Erin C. Berenz
    • 2
  • Michael J. Zvolensky
    • 1
    • 3
  1. 1.Department of PsychologyUniversity of HoustonHoustonUSA
  2. 2.Department of PediatricsUniversity of VirginiaCharlottesvilleUSA
  3. 3.Department of Behavioral Sciences, MD Anderson Cancer CenterUniversity of TexasHoustonUSA

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