A prospective examination of risk factors in the development of intrusions following a trauma analog

Abstract

Several factors have been linked to the severity of posttraumatic distress, although retrospective designs in much of the literature limit conclusions regarding the temporal relation between risk factors and corresponding symptoms. To address these concerns, the current project employed an analog trauma paradigm to assess the impact of background characteristics, stress response, and post-stressor affect regulation on subjective distress and intrusive memories experienced during the subsequent processing of emotional stimuli. University students (N = 184; 56% female, 42% White/Non-Hispanic) were shown graphic scenes of a televised suicide. Physiological activation was recorded during exposure with emotion ratings collected following the film. Participants then viewed a sadness- or humor-eliciting prime under instructions to inhibit or naturally express emotion. Intrusions experienced during the priming film and residual distress at study’s conclusion were rated prior to debriefing. Hierarchical regression identified reductions in emotional valence as a robust predictor of intrusions and distress. Sympathetic activation and exposure to the sadness prime were associated with intrusion frequency, whereas attenuated parasympathetic response predicted intrusion intensity. Expressive inhibition demonstrated a unique association with residual distress. Results suggest peritraumatic processes and post-exposure factors may hold more prominent relations with immediate trauma-related distress as compared to pre-existing survivor characteristics.

Model of Post-traumatic Growth in Newly Traumatized vs. Retraumatized Adolescents

“…2 Previous experience with trauma may have taught these individuals that intrusive symptoms are to be expected -unpleasant but not necessarily threatening -and that hypervigilance is both distressing and ultimately counter-productive. That intrusive thoughts are specifically linked to sympathetic activation has been demonstrated using an analog trauma paradigm, which found that increased skin conductance (a marker of sympathetic activity) during presentation of a distressing film clip was associated with greater frequency of intrusions afterward (40). A prospective, longitudinal emergency department study in which skin conductance response (SCR) data was gathered within h of a real-life trauma event demonstrated that SCR magnitude significantly predicted which individuals would go on to develop chronic PTSD, lasting at least 1 year (41).…”

Intrusive memories of trauma: A target for research bridging cognitive science and its clinical application

“…Finally, changes in state psychological factors such as those discussed above are usually accompanied by physiological stress responses (e.g., changes in skin conductance). For example, both greater mood change and higher physiological reactivity have been found to predict more intrusions immediately after an aversive film ( Ripley, Clapp, & Beck, 2017 ) and also in the 24 h after a virtual reality analogue trauma (an unexpected emergency situation simulated in an underground parking lot; Schweizer et al, 2017 ). In women, lower heart rate variability (regarded as a sign of less adaption to environmental changes) prior to watching a stressful film predicted more intrusive memories of the film ( Rombold-Bruehl et al, 2017 ), while peri-film decreases in heart rate predicted the frequency of image-based (rather than verbal) intrusive memories ( Chou, La Marca, Steptoe, & Brewin, 2014b ) (see also Holmes, Brewin, & Hennessy, 2004 ).…”

A novel virtual reality paradigm: Predictors for stress-related intrusions and avoidance behavior

“…TFP-studies indicated that similar vulnerability factors underlie the development of stress-related symptoms as in PTSD and ASD patients (Ripley, Clapp, & Beck, 2017). Pre-risk factors as maladaptive coping strategies (Davis & Clark, 1998;Regambal & Alden, 2009), higher levels of trait anxiety, depressive symptoms, trait dissociation and higher vividness of general mental imagery are related to higher intrusive memory frequency upon trauma induction (James et al, 2016).…”