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Perturbed threat monitoring following a traumatic event predicts risk for post-traumatic stress disorder

Published online by Cambridge University Press:  17 October 2013

R. Naim ,
I. Wald ,
A. Lior ,
D. S. Pine ,
N. A. Fox ,
G. Sheppes ,
P. Halpern  and
Y. Bar-Haim
R. Naim*
Affiliation:
School of Psychological Sciences, Tel Aviv University, Israel
I. Wald
Affiliation:
School of Psychological Sciences, Tel Aviv University, Israel
A. Lior
Affiliation:
Emergency Medicine Department, Tel Aviv Medical Center, Israel
D. S. Pine
Affiliation:
National Institute of Mental Health, Bethesda, MD, USA
N. A. Fox
Affiliation:
Department of Human Development, University of Maryland, College Park, MD, USA
G. Sheppes
Affiliation:
School of Psychological Sciences, Tel Aviv University, Israel
P. Halpern
Affiliation:
Emergency Medicine Department, Tel Aviv Medical Center, Israel Sackler Faculty of Medicine, Tel Aviv University, Israel
Y. Bar-Haim
Affiliation:
School of Psychological Sciences, Tel Aviv University, Israel The Sagol School of Neuroscience, Tel Aviv University, Israel
*
* Address for correspondence: R. Naim, MA, School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel. (Email: [email protected])
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Abstract

Background

Post-traumatic stress disorder (PTSD) is a chronic and difficult to treat psychiatric disorder. Objective, performance-based diagnostic markers that uniquely index risk for PTSD above and beyond subjective self-report markers could inform attempts to improve prevention and early intervention. We evaluated the predictive value of threat-related attention bias measured immediately after a potentially traumatic event, as a risk marker for PTSD at a 3-month follow-up. We measured the predictive contribution of attentional threat bias above and beyond that of the more established marker of risk for PTSD, self-reported psychological dissociation.

Method

Dissociation symptoms and threat-related attention bias were measured in 577 motor vehicle accident (MVA) survivors (mean age = 35.02 years, 356 males) within 24 h of admission to an emergency department (ED) of a large urban hospital. PTSD symptoms were assessed at a 3-month follow-up using the Clinician-Administered PTSD Scale (CAPS).

Results

Self-reported dissociation symptoms significantly accounted for 16% of the variance in PTSD at follow-up, and attention bias toward threat significantly accounted for an additional 4% of the variance in PTSD.

Conclusions

Threat-related attention bias can be reliably measured in the context of a hospital ED and significantly predicts risk for later PTSD. Possible mechanisms underlying the association between threat bias following a potentially traumatic event and risk for PTSD are discussed. The potential application of an attention bias modification treatment (ABMT) tailored to reduce risk for PTSD is suggested.

Keywords

Anxietyattention biasdissociationPTSD
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 10 , July 2014 , pp. 2077 - 2084
Copyright
Copyright © Cambridge University Press 2013 

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