Leaving the door open: Trauma, updating, and the development of PTSD symptoms.

Humans try to make sense of the world using hypotheses that were formed by prior experiences. After trauma, these hypotheses can be exaggerated and resistant to change. This may result in difficulties to update expectations regarding the negative outcomes associated with traumatic stimuli. Critically, it has been proposed that such difficulties may drive the development of posttraumatic stress disorder (PTSD). However, direct evidence on the associations between trauma and impaired expectation updating is still absent. Moreover, it remains unclear whether such an impairment is correlated with PTSD symptoms. To address these gaps, we compared the ability to update traumatic and neutral stimulus-outcome expectations in 81 active-duty firefighters. Participants completed a performance-based updating task and were assessed for PTSD symptoms. We predicted and found a selective impairment in updating trauma-related expectations. This impairment was evident for negative-to-positive but not for positive-to-negative updating. Moreover, impaired negative-to-positive updating was positively associated with PTSD symptoms. These findings support the predictive processing account of PTSD and suggest that strengthening updating processes could be an important goal for promoting resilience after trauma.

Social Functioning in Individuals Affected by Childhood Maltreatment: Establishing a Research Agenda to Inform Interventions.

Childhood maltreatment (CM) is linked to impairments in various domains of social functioning. Here, we argue that it is critical to identify factors that underlie impaired social functioning as well as processes that mediate the beneficial health effects of positive relationships in individuals exposed to CM. Key research recommendations are presented, focusing on: (1) identifying attachment-related alterations in specific inter- and intrapersonal processes (e.g., regulation of closeness and distance) that underlie problems in broader domains of social functioning (e.g., lack of perceived social support) in individuals affected by CM; (2) identifying internal (e.g., current emotional state) and external situational factors (e.g., cultural factors, presence of close others) that modulate alterations in specific social processes; and (3) identifying mechanisms that explain the positive health effects of intact social functioning. Methodological recommendations include: (1) assessing social processes through interactive and (close to) real-life assessments inside and outside the laboratory; (2) adopting an interdisciplinary, lifespan perspective to assess social processes, using multi-method assessments; (3) establishing global research collaborations to account for cultural influences on social processes and enable replications across laboratories and countries. The proposed line of research will contribute to globally develop and refine interventions that prevent CM and further positive relationships, which - likely through buffering the effects of chronic stress and corresponding allostatic load - foster resilience and improve mental and physical health, thereby reducing personal suffering and the societal and economic costs of CM and its consequences. Interventions targeting euthymia and psychological well-being are promising therapeutic concepts in this context.