RESUMEN
BACKGROUND AND OBJECTIVES: Fear generalization to harmless stimuli characterizes anxiety-related disorders, but much remains unknown about its determinants. Based on studies showing that mental imagery of threat can increase conditioned fear responding, we tested whether it also facilitates fear generalization, and whether threat inflation moderates this effect. METHODS: In a fear conditioning study, 120 participants first completed an acquisition phase, in which one of two pictures was followed by an aversive sound (human scream). Then, the sound was presented 11 times at an increasing (threat inflation) or constant volume (no threat inflation). Finally, a generalization stimulus was presented, and some participants were asked to imagine the last sound (threat rehearsal) and others were not (no threat rehearsal). RESULTS: Bayesian informative hypotheses tests indicated that imagery-based threat rehearsal increased generalization of threat expectancy, and, combined with threat inflation, it also resulted in stronger generalized distress. LIMITATIONS: due to the absence of a test phase, it is unclear whether our effects would transfer to other GSs and whether they would persist beyond the manipulation phase. CONCLUSIONS: Mental imagery of threat may put individuals at risk for fear generalization. Future studies should examine whether modulating imagery may prevent clinical anxiety.
Asunto(s)
Condicionamiento Clásico , Trastornos Fóbicos , Humanos , Teorema de Bayes , Miedo , Generalización PsicológicaRESUMEN
Safety behaviors are behavioral responses that aim to prevent or minimize an imminent threat when confronting a feared stimulus. Despite its adaptive purpose, preliminary evidence suggests that unnecessary safety behaviors to a safety stimulus induce threat beliefs to it. By allowing participants to engage in safety behaviors dimensionally, this study tested whether the degree of safety behaviors to a safety stimulus predicts the subsequent level of threat expectancies to it. To this end, participants first acquired safety behaviors to a threat-related stimulus (A). Safety behaviors then became available only for one safety stimulus (C), but not to another safety stimulus (B). After engaging in safety behaviors to C, participants exhibited greater threat expectancies to C compared to B, albeit with a small effect size. Importantly, the degree of safety behaviors predicted an increase in threat expectancies. The current findings suggest that safety behaviors to safety stimuli are linked to the development of threat beliefs.
Asunto(s)
Miedo , Conductas Relacionadas con la Salud , Humanos , Encuestas y CuestionariosRESUMEN
There is ample evidence showing that childhood maltreatment increases two to three fold the risk of victimization in adulthood. Various risk factors, including posttraumatic stress disorder (PTSD) symptoms, dissociation, self-blame, and alcohol abuse are related to revictimization. Although previous research examined associations between risk factors for revictimization, the evidence is limited and the proposed models mostly include a handful of risk factors. Therefore, it is critical to investigate a more comprehensive model explaining the link between childhood maltreatment and adulthood (re)victimization. Accordingly, this study tested a data-driven theoretical path model consisting of 33 variables (and their associations) that could potentially enhance understanding of factors explaining revictimization. Cross-sectional data derived from a multi-wave study were used for this investigation. Participants (N = 2156, age mean = 19.94, SD = 2.89) were first-year female psychology students in the Netherlands and New Zealand, who responded to a battery of questionnaires and performed two computer tasks. The path model created by structural equation modelling using modification indices showed that peritraumatic dissociation, PTSD symptoms, trauma load, loneliness, and drug use were important mediators. Attachment styles, maladaptive schemas, meaning in life, and sex motives connected childhood maltreatment to adulthood victimization via other factors (i.e., PTSD symptoms, risky sex behavior, loneliness, emotion dysregulation, and sex motives). The model indicated that childhood maltreatment was associated with cognitive patterns (e.g., anxious attachment style), which in turn were associated with emotional factors (e.g., emotion dysregulation), and then with behavioral factors (e.g., risky sex behavior) resulting in revictimization. The findings of the study should be interpreted in the light of the limitations. In particular, the cross-sectional design of the study hinders us from ascertaining that the mediators preceded the outcome variable.
RESUMEN
Generalization of conditioned fear is adaptive in some situations but maladaptive when fear excessively generalizes to innocuous stimuli with incidental resemblance to a genuine threat cue. Recently, empirical interest in fear generalization as a transdiagnostic explanatory mechanism underlying anxiety-related disorders has accelerated. As there are now several studies of fear generalization across multiple types of anxiety-related disorders, the authors conducted a meta-analysis of studies reporting behavioral measures (subjective ratings and psychophysiological indices) of fear generalization in anxiety-related disorder vs. comparison groups. We conducted systematic searches of electronic databases (conducted from January-October 2020) for fear generalization studies involving anxiety-related disorder groups or subclinical analog groups. A total of 300 records were full-text screened and two unpublished datasets were obtained, yielding 16 studies reporting behavioral fear generalization measures. Random-effects meta-analytic models and meta-regressions were applied to the identified data. Fear generalization was significantly heightened in anxiety-related disorder participants (N = 439) relative to comparison participants (N = 428). We did not identify any significant clinical, sample, or methodological moderators. Heightened fear generalization is quantitatively supported as distinguishing anxiety-related disorder groups from comparison groups. Evidence suggests this effect is transdiagnostic, relatively robust to experimental or sample parameters, and that generalization paradigms are a well-supported framework for neurobehavioral investigations of learning and emotion in anxiety-related disorders. We discuss these findings in the context of prior fear conditioning meta-analyses, past neuroimaging investigations of fear generalization in anxiety-related disorders, and future directions and challenges for the field.
Asunto(s)
Condicionamiento Clásico , Generalización Psicológica , Ansiedad/psicología , Trastornos de Ansiedad/psicología , Condicionamiento Clásico/fisiología , Miedo/fisiología , Generalización Psicológica/fisiología , HumanosRESUMEN
Exposure therapy is the recommended treatment for anxiety disorders, but many anxious individuals are unwilling to expose themselves to feared situations. Episodic simulation of future situations contributes to adaptive emotion regulation and motivates behavior. This study investigated whether future-oriented positive mental imagery reduces anticipatory anxiety and distress during exposure, and increases exposure willingness and duration. Forty-three individuals with moderate public speaking anxiety were randomized to a standardized positive mental imagery exercise about future public speaking or no-task. All participants were then asked to present in a virtual reality environment. Anticipatory anxiety reduced in the positive mental imagery group, but not in the control group. Additionally, the positive mental imagery group reported lower distress during exposure than the control group, but groups did not differ in exposure willingness. Due to limited variance, effects on exposure duration could not be tested. Future-oriented positive mental imagery is promising to prepare individuals for exposure to previously avoided situations.
Asunto(s)
Trastornos Fóbicos , Habla , Ansiedad/terapia , Trastornos de Ansiedad , Humanos , Imágenes en PsicoterapiaRESUMEN
Emotional cues draw attention, thereby enabling enhanced processing. Electrophysiological brain research in humans suggests that increased gamma band activity and decreased alpha band activity over posterior brain areas is associated with the allocation of attention. However, emotional events can alternate quickly, like rapidly changing news items and it remains unknown whether the modulation of brain oscillations happens in a stimulus induced manner, changing with each individual stimulus, or whether the events lead to prolonged, state-like changes. To investigate this, we measured the electroencephalogram (EEG) during a passive viewing task (N = 32) while emotional pictures International Affective Picture System (IAPS) were presented in blocks containing either pleasant and neutral or unpleasant and neutral pictures. As predicted, we found decreased alpha and increased gamma power over posterior areas in response to unpleasant compared to pleasant pictures (and also compared to neutral pictures for gamma power). When testing the neutral pictures of the unpleasant and pleasant block against each other, we found no significant difference, which speaks to a stimulus induced effect of alpha and gamma power rather than a state effect. In addition, the inter-trial interval (ITI) between the pictures did not differ between the unpleasant and pleasant block either, corroborating this conclusion. Since emotional pictures can at the same time elicit a freezing-like response and we were interested in whether this freezing-like response co-occurs with enhanced attention, we also collected postural sway data. However, within this EEG-setup, postural analyses indicated no stimulus-related effects nor a correlation with EEG-data. We interpret the alpha and gamma band results as reflecting event-related attention toward unpleasant compared to pleasant (and neutral) pictures and discuss this finding in light of previous EEG research and in combination with behavioral research on threat-induced reductions in body sway (freezing-like response).
RESUMEN
OBJECTIVE: A substantial number of sexual assault victims report experiencing some form of peritraumatic tonic immobility (TI). A self-report questionnaire that is widely used to assess TI retrospectively is the Tonic Immobility Scale (TIS). This study explored the factor structure of the TIS in a clinical sample of adolescent and young adults. METHOD: The sample comprised 131 female rape victims, aged 13-25, who were referred for specialized trauma-focused treatment. An exploratory factor analysis (EFA) was performed. RESULTS: The EFA showed support for a three-factor model, with factors TI, Fear, and Detachment. Item correlations ranged from .32 to .57 for TI, from .14 to .35 for Fear, and .29 for the two Detachment items. CONCLUSIONS: We found support for a three-factor solution distinguishing TI, fear, and detachment, suggesting the need to further develop the TIS with different subscales in varying age groups and clinical samples. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Asunto(s)
Víctimas de Crimen , Violación , Trastornos por Estrés Postraumático , Adolescente , Miedo , Femenino , Humanos , Pérdida de Tono Postural , Estudios Retrospectivos , Adulto JovenRESUMEN
We tested whether surprise elicits similar physiological changes as those associated with orienting and freezing after threat, as surprise also involves a state of interruption and attention for effective action. Moreover, because surprise is primarily driven by the unexpectedness of an event, initial physiological responses were predicted to be similar for positive, neutral, and negative surprises. Results of repetition-change studies (4 + 1 in Supplemental Materials) showed that surprise lowers heart rate (Experiments 1-4) and increases blood pressure (Experiment 4). No effects on body movement (Experiment 2) or finger temperature (Experiment 4) were found. When unexpected stimuli were presented more often (making them less surprising) heart rate returned to baseline, while blood pressure remained high (Experiment 4). These effects were not influenced by stimulus valence. However, second-to-second analyses within the first (surprising) block showed a tendency for a stronger increase in systolic blood pressure after negative vs. positive surprise.
Asunto(s)
Fenómenos Fisiológicos , Reflejo de Sobresalto , HumanosRESUMEN
Exposure-based therapy is an effective treatment for social anxiety, but some patients relapse. We used a novel virtual reality procedure to examine spontaneous recovery (i.e., a return of fear over time) and fear renewal (i.e., the return of fear after a context switch) in individuals with fear of public speaking. On Day 1, 32 participants received exposure training before a virtual audience. On Day 8, participants completed a spontaneous recovery phase, followed by a fear renewal test, in which they gave a presentation in front of a new (context switch) or the same audience (no context switch). After exposure, participants exhibited a lower heart rate, subjective distress, negative valence, and arousal. One week later, participants showed spontaneous recovery of heart rate, and the context switch group showed renewal of subjective distress, negative valence, and arousal. Future studies can use this procedure to test interventions aimed at improving long-term exposure effects in individuals with public speaking fear.
Asunto(s)
Terapia Implosiva , Realidad Virtual , Nivel de Alerta , Miedo , Humanos , HablaRESUMEN
The aim of this systematic review was to provide insight in inhibitory control (prepotent response inhibition and interference control) in trauma-exposed youth from a developmental perspective and exploring the effects of prolonged stress. A systematic search was conducted, resulting in 1722 abstracts. Of those, 33 studies met inclusion criteria. Twelve studies measured prepotent response inhibition (Go/no-go and Stop-signal task), 20 studies measured interference control (Flanker and Stroop task), and one measured both. Some studies indeed found evidence for prolonged trauma exposure impeding both subcomponents of inhibitory control, although others did not. At a later age, inhibitory control problems on task performance seem to disappear. However, distinct patterns of brain activity may suggest that those individuals employ compensation strategies. Together, the findings may suggest that non-specific inhibitory control problems occur after prolonged trauma exposure, with older youth possibly employing compensation strategies on the tasks. Future studies may provide a clearer picture of the compensation strategies and the circumstances in which they become visible.
Asunto(s)
Inhibición Psicológica , Desempeño Psicomotor , Adolescente , Humanos , Tiempo de Reacción , Transmisión Sináptica , Análisis y Desempeño de TareasRESUMEN
BACKGROUND: Tonic immobility (TI; a state of motor arrest during threat) and has been found to be associated with the development of psychopathology. It also hindered recovery from posttraumatic stress disorder (PTSD) after pharmacological treatment. The present study investigated the role of TI in recovery from PTSD in a large representative community sample with mixed traumas outside an exclusive treatment context. METHODS: Participants with PTSD from the panel for Longitudinal Internet Studies for the Social Sciences (LISS) completed measures for trauma, PTSD symptoms, and peritraumatic responses (fear, dissociation, and TI) in two subsequent years. Traumatized participants with PTSD were selected for the analyses (Nâ¯=â¯262). RESULTS: TI was a relevant predictor for increased PTSD symptoms in year 2 after controlling for peritraumatic fear, peritraumatic dissociation, and PTSD symptoms in year 1, especially in abuse victims. Peritraumatic fear and dissociation no longer predicted PTSD in year 2 after entering TI in the model. CONCLUSIONS: Our results indicate that TI may indeed hinder recovery from PTSD. TI may thus be a relevant factor to take into account after trauma and in treatment. The effects of TI may be especially negative for abuse victims.
Asunto(s)
Trastornos por Estrés Postraumático , Trastornos Disociativos , Miedo , Humanos , Pérdida de Tono PosturalRESUMEN
Importance: Cognitive behavioral therapy is recommended for anxiety-related disorders, but evidence for its long-term outcome is limited. Objective: This systematic review and meta-analysis aimed to assess the long-term outcomes after cognitive behavioral therapy (compared with care as usual, relaxation, psychoeducation, pill placebo, supportive therapy, or waiting list) for anxiety disorders, posttraumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). Data Sources: English-language publications were identified from PubMed, PsycINFO, Embase, Cochrane, OpenGrey (1980 to January 2019), and recent reviews. The search strategy included a combination of terms associated with anxiety disorders (eg, panic or phobi*) and study design (eg, clinical trial or randomized controlled trial). Study Selection: Randomized clinical trials on posttreatment and at least 1-month follow-up effects of cognitive behavioral therapy compared with control conditions among adults with generalized anxiety disorder, panic disorder with or without agoraphobia, social anxiety disorder, specific phobia, PTSD, or OCD. Data Extraction and Synthesis: Researchers independently screened records, extracted statistics, and assessed study quality. Data were pooled using a random-effects model. Main Outcomes and Measures: Hedges g was calculated for anxiety symptoms immediately after treatment and at 1 to 6 months, 6 to 12 months, and 12 months or more after treatment completion. Results: Of 69 randomized clinical trials (4118 outpatients) that were mainly of low quality, cognitive behavioral therapy compared with control conditions was associated with improved outcomes after treatment completion and at 1 to 6 months and at 6 to 12 months of follow-up for a generalized anxiety disorder (Hedges g, 0.07-0.40), panic disorder with or without agoraphobia (Hedges g, 0.22-0.35), social anxiety disorder (Hedges g, 0.34-0.60), specific phobia (Hedges g, 0.49-0.72), PTSD (Hedges g, 0.59-0.72), and OCD (Hedges g, 0.70-0.85). At a follow-up of 12 months or more, these associations were still significant for generalized anxiety disorder (Hedges g, 0.22; number of studies [k] = 10), social anxiety disorder (Hedges g, 0.42; k = 3), and PTSD (Hedges g, 0.84; k = 5), but not for panic disorder with or without agoraphobia (k = 5) and could not be calculated for specific phobia (k = 1) and OCD (k = 0). Relapse rates after 3 to 12 months were 0% to 14% but were reported in only 6 randomized clinical trials (predominantly for panic disorder with or without agoraphobia). Conclusions and Relevance: The findings of this meta-analysis suggest that cognitive behavioral therapy for anxiety-related disorders is associated with improved outcomes compared with control conditions until 12 months after treatment completion. At a follow-up of 12 months or more, effects were small to medium for generalized anxiety disorder and social anxiety disorder, large for PTSD, and not significant or not available for other disorders. High-quality randomized clinical trials with 12 months or more of follow-up and reported relapse rates are needed.
Asunto(s)
Trastornos de Ansiedad/terapia , Terapia Cognitivo-Conductual , Humanos , Trastorno Obsesivo Compulsivo/terapia , Trastornos por Estrés Postraumático/terapia , Resultado del TratamientoRESUMEN
BACKGROUND AND OBJECTIVES: Imagery rescripting is an effective treatment strategy for trauma related disorders, but its underlying mechanisms are still largely unknown. The aim of the present study was to test whether a) imagery (versus writing) is essential in the process of rescripting, and b) rescripting affects emotional memories on an implicit level. METHODS: Healthy participants were subjected to an experimental trauma ('trauma film'), and randomly allocated to four conditions: recall of film + Imagery Rescripting (ImRs), recall of film + Writing Rescripting (WRs), recall only (ImRE), or no recall + no manipulation (NM). Next, participants recorded intrusion frequency and distress during one week, after which they executed a visual interference task (VIT) including neutral and trauma film stills, to access implicit emotional memory. RESULTS: Main findings were that ImRs and WRs resulted in fewer intrusions than NM, with no differences between both rescripting conditions. We did not find an effect on intrusion distress and the VIT. LIMITATIONS: Stills in the VIT were distracted from all four film scenes, whereas rescripting was done on one scene only, possibly obscuring the effect. Also, an analogue sample was used, which may limit generalizability to clinical samples. CONCLUSIONS: We replicated previous effects of ImRs on intrusion development. Furthermore, no superior effect of imagery as key modality for rescripting was found; writing seems a viable alternative. Measures for implicit emotional memory such as the VIT may have to be applied relatively soon after the experimental session (e.g., same day as the experimental session).
Asunto(s)
Imágenes en Psicoterapia/métodos , Recuerdo Mental , Trastornos por Estrés Postraumático/psicología , Escritura , Adolescente , Adulto , Emociones , Femenino , Humanos , Masculino , Memoria , Persona de Mediana Edad , Películas Cinematográficas , Adulto JovenRESUMEN
Patients with post-traumatic stress disorder frequently and involuntarily experience intrusions, which are strongly linked to the trauma hotspot. Voluntary memory characteristics (i.e., vividness and unpleasantness) of this hotspot can be reduced by performing a dual-task, such as making horizontal eye movements, which is frequently used in Eye Movement Desensitization and Reprocessing. We tested whether such dual-task interventions would also reduce involuntary memory (i.e., intrusions). Moreover, we examined if changes in hotspot vividness and unpleasantness predicted intrusion frequency. Additionally, we examined whether the effects were dependent on dual-task modality. We tested this in three experiments. Participants watched a trauma film and performed one of the interventions 10-min post-film (1) Recall + Eye movements, (2) Recall + Counting, or (3) No-Task Control. Before and after the intervention, participants rated the hotspot vividness and unpleasantness. They recorded intrusive memories about the film in a diary for a week. Unexpectedly, we found that hotspot vividness and unpleasantness ratings were not affected by the intervention. However, the prolonged (experiment 2), but not standard (experiment 1), dual-task interventions resulted in a lower number of intrusions, regardless of modality. However, this effect was not replicated in experiment 3. We discuss potential explanations and present suggestions for future research.
Asunto(s)
Atención , Movimientos Oculares , Memoria a Corto Plazo , Recuerdo Mental , Trauma Psicológico/psicología , Adolescente , Adulto , Desensibilización y Reprocesamiento del Movimiento Ocular , Femenino , Humanos , Masculino , Memoria , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/rehabilitación , Análisis y Desempeño de Tareas , Adulto JovenRESUMEN
Exposure-based treatment for anxiety disorders is effective for many patients, but relapse is not uncommon. One predictor of the return of fear is the negative valence of fear-relevant stimuli. The aim of the current experiments was to examine whether counterconditioning with positive film clips reduces this negative stimulus valence as well as the return of fear, compared to standard extinction training and to an extinction training with non-contingent exposure to the positive film clips. Participants were 87 students in Experiment 1 (three-day paradigm), and 90 students in Experiment 2 (one-day paradigm). They first underwent a differential acquisition phase, in which one of three pictures was paired with an electric shock. They were then randomly allocated to one of the three intervention groups. Afterwards, they underwent a test phase in which pictures were presented without shock (to measure spontaneous recovery of fear), which was followed by unsignaled shocks to induce reinstatement of extinguished fear. Outcome variables were self-reported stimulus valence, shock expectancy, skin conductance, and fear-potentiated startle. In both experiments, counterconditioning decreased negative stimulus valence, relative to the other interventions, but it did not reduce spontaneous fear recovery or fear reinstatement. Overall, our findings do not support the notion that counterconditioning reduces return of fear.
Asunto(s)
Condicionamiento Psicológico , Extinción Psicológica , Miedo , Adolescente , Adulto , Trastornos de Ansiedad/terapia , Femenino , Respuesta Galvánica de la Piel , Humanos , Terapia Implosiva , Masculino , Músculos Oculomotores/fisiología , Reflejo de Sobresalto/fisiología , Adulto JovenRESUMEN
BACKGROUND: The peri-traumatic stress response is a strong predictor of symptom development after trauma exposure. Regarding witnessing trauma, the stress response might depend on the susceptibility to others' emotions (emotional contagion, EC). This study investigated whether EC moderates the immediate stress response using a trauma film paradigm. METHODS: Ninety-five healthy participants were randomly exposed to a trauma or a neutral film. Perceived stressfulness of the film and pre-to post-film changes in self-reported anxiety, heart rate and saliva cortisol levels were assessed. EC towards negative and positive emotions was measured using the emotional contagion scale and its emotion-specific subscales. RESULTS: Overall, the trauma film was perceived as distressing and elicited an increase in self-reported anxiety, heart rate and saliva cortisol levels relative to the neutral film. EC towards negative emotions was positively related to the perceived stressfulness of the film, increased anxiety and increased heart rate. The association with saliva cortisol levels was also in the expected direction, but not statistically significant. These associations were not found for EC towards positive emotions. DISCUSSION: EC towards negative emotions may be an important predictor of trauma exposure outcomes. Further research should clarify its specific contribution in witnessing and undergoing trauma.
Asunto(s)
Emociones/fisiología , Autoinforme , Estrés Fisiológico/fisiología , Heridas y Lesiones/psicología , Adolescente , Adulto , Ansiedad/fisiopatología , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Hidrocortisona/metabolismo , Masculino , Estimulación Luminosa , Saliva/metabolismo , Adulto JovenRESUMEN
Exposure-based therapies are effective for anxiety disorders, but relapse remains a problem. One explanation might be that exposure therapy reduces threat expectancy but not related feelings of unpleasantness (negative valence of the conditioned stimulus; CS+), which may promote return of threat expectancy and associated fear. Laboratory research has indeed shown that fear extinction leaves negative valence of the conditioned stimulus (CS+) intact. Here, we tested whether adding positive consequences to the CS+ during extinction, a procedure known as counterconditioning, would change the valence of the CS+ and thereby prevent return of threat expectancy. Participants underwent Acquisition (day 1), Intervention (counterconditioning or extinction; day 2), and Spontaneous recovery and Reinstatement (day 3). As expected, threat expectancy ratings during the Spontaneous recovery and Reinstatement tests were lower after counterconditioning than after extinction, but counterconditioning did not reduce CS + negative valence more than extinction. Alternative mechanisms and clinical implications are discussed.
Asunto(s)
Condicionamiento Clásico/fisiología , Extinción Psicológica/fisiología , Miedo/fisiología , Miedo/psicología , Ansiedad/fisiopatología , Ansiedad/psicología , Femenino , Respuesta Galvánica de la Piel/fisiología , Humanos , Masculino , Trastornos Fóbicos/fisiopatología , Trastornos Fóbicos/psicología , Recurrencia , Adulto JovenRESUMEN
Frontal EEG theta/beta ratio (TBR; negatively associated with attentional control, or AC) was previously reported to moderate threat-level dependent attentional bias in a pictorial dot-probe task, interacting with trait anxiety. Unexpectedly, this was independent from processing stage (using cue-target delays of 200 and 500 ms) and also not observed for self-reported trait AC. We therefore aimed to replicate these effects of TBR and trait anxiety and to test if effects of early versus late processing stages are evident for shorter cue-target delays. This study also revisited the hypothesis that TBR and self-reported trait AC show similar effects. Fifty-three participants provided measurements of frontal TBR, self-reported trait AC, trait anxiety, and dot-probe task bias for mild and high threat pictures using the same dot-probe task, but this time with 80- and 200-ms cue-target delays. Results indicated that higher TBR predicted more attention to mild than high threat, but this was independent from trait anxiety or delay. Lower self-reported trait AC predicted more attention to mild than high threat, only after 200 ms (also independent of trait anxiety). We conclude that the moderating effect of TBR on threat-level dependent dot-probe task bias was replicated, but not the role of trait anxiety, and this study partially confirms that effects of trait AC are more dominant in later processing.
Asunto(s)
Afecto/fisiología , Ansiedad , Sesgo Atencional/fisiología , Ritmo beta , Encéfalo/fisiología , Personalidad , Ritmo Teta , Percepción Visual/fisiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Autoinforme , Adulto JovenRESUMEN
Tonic Immobility (TI) is an evolved defence response, characterized by physical immobility. Peritraumatic TI has been linked to posttraumatic stress disorder (PTSD). However, samples sizes in clinical studies have been small, and little is known about TI reactions post trauma, for instance during trauma reminders. The prevalence of peritraumatic TI and TI during re-experiencing the traumatic event was examined by self-report in 184 patients with chronic PTSD. Moderate peritraumatic TI was reported by 26.6% of the participants (nâ¯=â¯49) and extreme peritraumatic TI by 52.2% (nâ¯=â¯96). During re-experiencing the traumatic event, 35.3% (nâ¯=â¯65) reported moderate TI, and 37.0% (nâ¯=â¯68) extreme TI. Peritraumatic TI was related to PTSD symptom severity and TI during re-experiencing mediated this relationship. In line with previous findings, reports of peritraumatic TI were high among PTSD patients. In addition, we showed that it often re-occurred during re-experiencing the traumatic event. The prevalence of TI at different stages post trauma warrants future study.
Asunto(s)
Pérdida de Tono Postural , Trastornos por Estrés Postraumático/psicología , Adulto , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Background: Intrusive trauma memories are a key symptom of posttraumatic stress disorder (PTSD), so disrupting their recurrence is highly important. Intrusion development was hindered by visuospatial interventions administered up to 24 hours after analogue trauma. It is unknown whether interventions can be applied later, and whether modality or working-memory load are crucial factors. Objectives: This study tested: (1) whether a visuospatial task would lead to fewer intrusions compared to a reactivation-only group when applied after memory reactivation four days after analogue trauma exposure (extended replication), (2) whether both tasks (i.e. one aimed to be visuospatial, one more verbal) would lead to fewer intrusions than the reactivation-only group (intervention effect), and (3) whether supposed task modality (visuospatial or verbal) is a critical component (modality effect). Method: Fifty-four participants were randomly assigned to reactivation+Tetris (visuospatial), reactivation+Word games (verbal), or reactivation-only (no task). They watched an aversive film (day 0) and recorded intrusive memories of the film in diary A. On day 4, memory was reactivated, after which participants played Tetris, Word games, or had no task for 10 minutes. They then kept a second diary (B). Informative hypotheses were evaluated using Bayes factors. Results: Reactivation+Tetris and reactivation+Word games resulted in relatively fewer intrusions from the last day of diary A to the first day of diary B than reactivation-only (objective 1 and 2). Thus, both tasks were effective even when applied days after analogue trauma. Reactivation-only was not effective. Reactivation+Word games appeared to result in fewer intrusions than reactivation+Tetris (objective 3; modality effect), but this evidence was weak. Explorative analyses showed that Word games were more difficult than Tetris. Conclusions: Applying a task four days after the trauma film (during memory reconsolidation) was effective. The modality versus working-memory load issue is inconclusive.
Planteamiento: Los recuerdos intrusivos de trauma son un síntoma clave del trastorno de estrés postraumático (TEPT), por lo que es muy importante interrumpir su recurrencia. Se obstaculizó el desarrollo de intrusiones mediante intervenciones visuoespaciales administradas hasta 24 horas después de un trauma analógico. Se desconoce si las intervenciones pueden ser aplicadas más adelante, y si la modalidad o la carga de la memoria de trabajo son factores cruciales. Objetivos: El estudio comprobaba: (1) si una tarea visuoespacial conduciría a menos intrusiones en comparación con un grupo de solo reactivación cuando se aplicaba después de la reactivación del recuerdo, 4 días después de la exposición al trauma analógico (replicación extendida); (2) si ambas tareas (una pretendía ser más visuoespacial y otra más verbal) darían lugar a menos intrusiones que el grupo de solo reactivación (efecto de la intervención), y 3) si la supuesta modalidad de la tarea (visuoespacial o verbal) es un componente fundamental (efecto de la modalidad). Método: Se asignaron aleatoriamente 54 participantes a reactivación + Tetris (visuoespacial), reactivación + juegos de palabras (verbal), o solo reactivación (sin tarea). Vieron una película aversiva (día 0) y registraron recuerdos intrusivos de la película en el diario A. El cuarto día, se reactivó el recuerdo, después de lo cual los participantes jugaron al Tetris, a juegos de palabras, o no hicieron ninguna tarea durante 10 minutos. Luego escribieron un segundo diario (B). Se evaluaron las hipótesis informativas con factores de Bayes. Resultados: Reactivación + Tetris y reactivación + juegos de palabras dieron como resultado relativamente menos intrusiones que sólo la reactivación (objetivo 1 y 2), desde el último día del diario A hasta el primer día del diario B. Por lo tanto, ambas tareas fueron eficaces incluso cuando se aplicaron días después del trauma analógico. La reactivación por separado no fue efectiva. Reactivación + juegos de palabras pareció resultar en menos intrusiones que reactivación + Tetris (objetivo 3, efecto de la modalidad), pero esta evidencia era débil. Los análisis exploratorios mostraron que los juegos de palabras eran más difíciles que el Tetris. Conclusiones: La aplicación de una tarea 4 días después de la película traumática (durante la reconsolidación de la memoria) fue efectiva. La modalidad versus el problema de la carga de memoria de trabajo no es concluyente.