High rates of nonresponse to evidence-based treatment for posttraumatic stress disorder (PTSD) have fueled the search for improved intervention. Evidence suggests that improvements in dispositional mindfulness (i.e., tendency to attend to the present with nonjudgment and nonreactivity) may help reduce PTSD symptoms. While some research suggests that transdiagnostic mindfulness-based interventions particularly target avoidance symptoms, the association between dispositional mindfulness and avoidance has yet to be systematically examined. To address this gap, we examined peer-reviewed studies that reported quantitative associations between avoidance and dispositional mindfulness among trauma-exposed adults, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. Sixteen studies were identified for final review from PsycINFO and PubMed databases. Results suggest that mindfulness has a weak relationship with effortful avoidance. This weak relationship may be obscured in studies where effortful avoidance is measured among other symptoms (e.g., anhedonia). Mindfulness appeared to have stronger associations with symptoms of hyperarousal and negative alterations in cognition and mood. An important clinical implication is that high effortful avoidance may manifest among patients who report strong mindfulness skills. It may be helpful for clinicians to carefully assess how mindfulness is being used to cope.

中文翻译：

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性格正念和创伤后应激障碍症状学的系统回顾：回避的有针对性的检查

创伤后应激障碍（PTSD）循证治疗无反应率很高，促使人们寻求改进的干预措施。有证据表明，性格正念的改善（即以不评判和不反应的方式关注当下的倾向）可能有助于减轻创伤后应激障碍（PTSD）症状。虽然一些研究表明基于正念的跨诊断干预措施特别针对回避症状，但性格正念与回避之间的关联尚未得到系统研究。为了解决这一差距，我们检查了同行评审的研究，这些研究报告了遭受创伤的成年人的回避和性格正念之间的定量关联，遵循系统评价和荟萃分析 2009 年指南的首选报告项目。从 PsycINFO 和 PubMed 数据库中确定了 16 项研究进行最终审查。结果表明，正念与努力回避的关系较弱。在将努力回避与其他症状（例如快感缺失）一起进行测量的研究中，这种微弱的关系可能会被掩盖。正念似乎与过度觉醒的症状以及认知和情绪的负面改变有更强的关联。一个重要的临床意义是，在正念技能较强的患者中可能会表现出高度努力的回避。临床医生仔细评估如何使用正念来应对可能会有所帮助。