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Thus, the status of the science underpinning the mutual maintenance hypothesis at this time only yields indirect agreement.
The present study revealed that lower levels of social integration and activity were associated with elevated levels of PTSD symptoms, indicating a mutual maintenance effect.
Considering the association of chronic pain and symptoms of posttraumatic stress disorder a model of shared vulnerability and mutual maintenance is discussed.
Possible reasons for the high frequency may be the mutual maintenance model [ 23, 24], which holds that components of anxiety disorders maintain or worsen symptoms of pain, and components of pain maintain or worsen the symptoms of anxiety disorders.
Regardless of the method of onset, however, once anxiety and AUDs co-occur, the mutual maintenance model suggests that these comorbid disorders can become engaged in a feed-forward cycle that could be progressive if left untreated.
This intuitively appealing approach theoretically is matched to the mutual maintenance model, is efficient, and communicates to clients that their dual problems are in fact intertwined and equally require management.
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In light of the mutual-maintenance patterns mentioned earlier this may be a quite significant benefit.
Collectively, these independent findings are consistent with the mutual-maintenance model of comorbid anxiety and AUDs.
This positive feedback loop often is characterized as a feed-forward or mutual-maintenance pattern.
Empirical support for this mutual-maintenance model comes from various sources, which in many ways reflects a synthesis of data supporting the three developmental pathways.
As reviewed earlier, one implication of the mutual-maintenance model of comorbidity is that neglecting to treat the second disorder would place individuals at high risk of relapse to the disorder that was treated, and published studies have supported this notion (e.g., Bruce et al. 2005; Driessen et al. 2001; Kushner et al. 2005).
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