The impact of pre-existing anxiety on affective and cognitive processing of a Virtual Reality analogue trauma

Abstract

Dysfunctional processing of traumatic events may be in particular related to high trait anxiety as a pre-traumatic risk factor for the development of post-traumatic stress disorder (PTSD). However, as this has rarely been investigated in prospective, experimental studies, we aimed to analyse the association between high trait anxiety and affective as well as cognitive processing of stress using a new prospective Virtual Reality analogue trauma paradigm to overcome limitations of retrospective or current analogue designs. Individuals with high and low trait anxiety (N = 80) were exposed to a multi-sensory Virtual Reality emergency scenario while psychophysiological stress response, emotion regulation and intrusive memories were assessed. Our results showed that high trait anxiety individuals display increased (i) subjective stress responses, (ii) emotion dysregulation and (iii) intrusive memories upon VR analogue trauma exposure. In particular, our sample of high trait anxiety individuals displayed limited access to different emotion regulation strategies as well as increased worry and rumination regarding perceived intrusive memories. Considering the complex interplay of multiple risk factors, our findings suggests that peri-traumatic affective processing seems to mediate high trait anxiety and post-traumatic intrusive memories thereby pointing out the central role of peri-traumatic processes for intrusion development. In addition, HA as a modulating pre-traumatic risk factor might further increase the risk of later dysfunctional processing of an analogue trauma by interacting with factors of affective processing during analogue trauma exposure. Implications of these findings which may contribute to a higher risk to develop PTSD are discussed.

Psychophysiological reactivity, coping behaviour and intrusive memories upon multisensory Virtual Reality and Script-Driven Imagery analogue trauma: A randomised controlled crossover study

“…Both paradigms induced analogue intrusive memories one day after the analogue trauma. In line with previous studies, the frequency of intrusive visual images and thoughts was higher than the frequency of intrusive sounds/smells ( Dibbets & Schulte-Ostermann, 2015 ; Krans et al, 2010 ; Schweizer et al, 2017 ). Increased intrusive memories in our study might be related to the relatively high levels of peri-traumatic arousal in our study.…”

“…Multisensory components were added to both paradigms with the intention to make them stronger. Previous studies by our group have found that the VR paradigm can induce emotional stress comparable to viewing a 2-D trauma film and intrusive memories ( Becker-Asano et al, 2011 ; Schweizer et al, 2017 ). The SDI paradigm has also been shown to elicit psychophysiological stress (unpublished results).…”

“…Virtual Reality (VR) is a promising experimental stress induction method allowing for first-person perspective experiences ( Becker-Asano et al, 2011 ; Dibbets & Schulte-Ostermann, 2015 ; Schweizer et al, 2017 ). In VR, movements with real-time visual-auditory orientation and 3-D views are enabled by a joystick and a head-tracked head-mounted display.…”

Anxiety, Post-Traumatic Stress, and Burnout in Health Professionals during the COVID-19 Pandemic: Comparing Mental Health Professionals and Other Healthcare Workers

“…As expected, professionals who reported trait anxiety had higher odds of exhibiting state anxiety, post-traumatic symptoms, emotional exhaustion, depersonalization, and low personal accomplishment compared to professionals who reported no trait anxiety. Previous literature suggests that anxiety can accentuate post-traumatic stress reactions: individuals with trait anxiety may respond more extremely to a traumatic stressor, distressed by not only the event but also their own reactions [58,59].…”

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 ).…”