Temporal associations between adolescents' psychological inflexibility and posttraumatic stress symptoms after a super typhoon: Examining the mediation of cognitive emotion regulation.

This study investigated the temporal associations between psychological inflexibility, adaptive and maladaptive cognitive emotion regulation (CER), and posttraumatic stress symptoms (PTSS) in adolescents after a super typhoon. We surveyed adolescents 3 (November 2019, T1), 15 (November 2020, T2), and 27 (November 2021, T3) months after the super typhoon Lekima. Cross-lagged panel analysis was conducted among 1342 adolescents (Age: M = 14.14, SD = 1.60; 54.9 % girls) who participated in at least two out of three measurements. We further tested the mediation effects of CER in the relationship between psychological inflexibility and PTSS. Our main results indicated that psychological inflexibility at T1 directly influenced PTSS at T2, maladaptive CER at T2 mediated the association between PTSS at T1 and psychological inflexibility at T3. In addition, CER and PTSS shared bidirectional association from T1 to T2, whereas PTSS at T2 unidirectionally influenced maladaptive CER at T3. Psychological inflexibility at T2 was related with adaptive CER at T3. The results indicated that psychological inflexibility directly exacerbated PTSS in the short time after trauma, whereas PTSS indirectly exacerbated future psychological inflexibility in the longer time after trauma. For intervention designs, the broad focus on psychological inflexibility, adaptive and maladaptive CER, and PTSS shortly after trauma should be gradually narrowed to reducing maladaptive CER and PTSS in the longer time after trauma.