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1.  Attentional Interference by Threat and Posttraumatic Stress Disorder: The Role of Thought Control Strategies 
Cognition & emotion  2013;27(7):1314-1325.
Attentional interference by threat is associated with PTSD, but the mechanisms of this relationship remain unclear. Attentional interference might be related to increased use of maladaptive thought control strategies, such as suppressing unwanted thoughts (thought suppression) or replacing threatening thoughts with everyday concerns (worry), which increase PTSD risk. Conversely, attentional interference might be associated with reduced use of adaptive strategies, such as talking about threatening thoughts (social control) which decrease PTSD risk. This study tested if thought control strategies mediate the relationship between attentional interference and PTSD. Sixty-one male Vietnam-era veterans completed measures of PTSD symptoms and thought control strategies. Participants also completed a visual search task measuring attentional interference, which required participants to identify a target letter string among a group of threat or neutral words. Attentional interference by threat was related to PTSD symptoms, and mediation analyses revealed significant indirect effects of attentional interference through thought suppression and worry. Attentional interference was related to reexperiencing and avoidance, but not hyperarousal, symptom clusters. Thought suppression was a unique mediator for reexperiencing, whereas thought suppression and worry both mediated the relationship with avoidance. These results offer evidence for maladaptive thought control strategies as a mechanism linking attentional biases for threat to PTSD.
PMCID: PMC3748244  PMID: 23517445
attention; PTSD; information processing bias; thought control; thought suppression
2.  Trauma Reactivity, Avoidant Coping, and PTSD Symptoms: A Moderating Relationship? 
Journal of Abnormal Psychology  2011;120(1):240-246.
In the immediate aftermath of a traumatic event, many individuals experience physiological reactivity in response to reminders of the traumatic event that typically lessens over time. However, an overreliance on avoidant coping strategies may interfere with the natural recovery process, particularly for those who are highly reactive to trauma reminders. In the current investigation, we examined avoidant coping as a moderator of the association between heart rate reactivity to a trauma monologue measured shortly after a traumatic event and severity of posttraumatic stress disorder (PTSD) symptoms measured several months later. Fifty-five female survivors of assault completed PTSD diagnostic interviews and a self-report coping measure and participated in a trauma monologue procedure that included continuous heart rate measurement. These procedures were completed within 1 month of the assault and again 3 months postassault. After we controlled for the effect of initial symptom levels, the interaction of heart rate reactivity to the trauma monologue and avoidant coping measured at Time 1 was associated with PTSD symptom severity at Time 2. Individuals who are relatively highly reliant on avoidant coping strategies and relatively highly reactive to trauma reminders may be at greatest risk of maintaining or potentially increasing their PTSD symptoms within the first few months following the trauma. These findings may help inform early intervention efforts for survivors of traumatic events.
PMCID: PMC3336155  PMID: 21319932
posttraumatic stress disorder; avoidance; coping; psychophysiology; heart rate
3.  Sex differences in fear conditioning in posttraumatic stress disorder 
Women are twice as likely as men to develop Posttraumatic Stress Disorder (PTSD). Abnormal acquisition of conditioned fear has been suggested as a mechanism for the development of PTSD. While some studies of healthy humans suggest that women are either no different or express less conditioned fear responses during conditioning relative to men, differences in the acquisition of conditioned fear between men and women diagnosed with PTSD has not been examined.
Thirty-one participants (18 men; 13 women) with full or subsyndromal PTSD completed a fear conditioning task. Participants were shown computer-generated colored circles that were paired (CS+) or unpaired (CS−) with an aversive electrical stimulus and skin conductance levels were assessed throughout the task.
Repeated measures ANOVA indicated a significant sex by stimulus interaction during acquisition. Women had greater differential conditioned skin conductance responses (CS + trials compared to CS− trials) than did men, suggesting greater acquisition of conditioned fear in women with PTSD.
In contrast to studies of healthy individuals, we found enhanced acquisition of conditioned fear in women with PTSD. Greater fear conditioning in women may either be a pre-existing vulnerability trait or an acquired phenomenon that emerges in a sex-dependent manner after the development of PTSD. Characterizing the underlying mechanisms of these differences is needed to clarify sex-related differences in the pathophysiology of PTSD.
PMCID: PMC3806498  PMID: 23107307
Sex differences; Learning; Conditioning; Fear; Posttraumatic stress disorder; Galvanic skin response
4.  Differential Associations Between Partner Violence and Physical Health Symptoms Among Caucasian and African American Help-Seeking Women 
The relationship between partner violence and physical health symptoms is well-established. Although some researchers have theorized that the physical health effects of partner violence may be worse for ethnic minority women, there is little research addressing this topic. The current study examined whether African American women demonstrate a differential association in this relationship than Caucasian women. This study included 323 women (232 African American, 91 Caucasian) who participated in a larger investigation of the psychological and psychophysiological correlates of recent partner violence among women seeking help for the abuse. Race was examined as a moderator of the relationship between partner violence frequency and physical health symptoms. Although mean levels of partner violence frequency and physical health symptoms did not significantly differ between African American and Caucasian women, linear regression analyses demonstrated a significant positive relationship between partner violence frequency and physical health symptoms for African American women; whereas there was no association observed between these variables for Caucasian women. Post hoc analyses revealed that posttraumatic stress disorder symptoms partially mediated the association between partner violence frequency and physical health symptoms for the African American women. The current findings underscore the importance of considering race when studying the effect of partner violence on women’s health.
PMCID: PMC3632218  PMID: 23616911
race; women; partner violence; physical health; moderation
5.  Predicting post-trauma stress symptoms from pre-trauma psychophysiologic reactivity, personality traits and measures of psychopathology 
Most individuals exposed to a traumatic event do not develop post-traumatic stress disorder (PTSD), although many individuals may experience sub-clinical levels of post-traumatic stress symptoms (PTSS). There are notable individual differences in the presence and severity of PTSS among individuals who report seemingly comparable traumatic events. Individual differences in PTSS following exposure to traumatic events could be influenced by pre-trauma vulnerabilities for developing PTSS/PTSD.
Pre-trauma psychological, psychophysiological and personality variables were prospectively assessed for their predictive relationships with post-traumatic stress symptoms (PTSS). Police and firefighter trainees were tested at the start of their professional training (i.e., pre-trauma; n = 211) and again several months after exposure to a potentially traumatic event (i.e., post-trauma, n = 99). Pre-trauma assessments included diagnostic interviews, psychological and personality measures and two psychophysiological assessment procedures. The psychophysiological assessments measured psychophysiologic reactivity to loud tones and the acquisition and extinction of a conditioned fear response. Post-trauma assessment included a measure of psychophysiologic reactivity during recollection of the traumatic event using a script-driven imagery task.
Logistic stepwise regression identified the combination of lower IQ, higher depression score and poorer extinction of forehead (corrugator) electromyogram responses as pre-trauma predictors of higher PTSS. The combination of lower IQ and increased skin conductance (SC) reactivity to loud tones were identified as pre-trauma predictors of higher post-trauma psychophysiologic reactivity during recollection of the traumatic event. A univariate relationship was also observed between pre-trauma heart rate (HR) reactivity to fear cues during conditioning and post-trauma psychophysiologic reactivity.
The current study contributes to a very limited literature reporting results from truly prospective examinations of pre-trauma physiologic, psychologic, and demographic predictors of PTSS. Findings that combinations of lower estimated IQ, greater depression symptoms, a larger differential corrugator EMG response during extinction and larger SC responses to loud tones significantly predicted higher PTSS suggests that the process(es) underlying these traits contribute to the pathogenesis of subjective and physiological PTSS. Due to the low levels of PTSS severity and relatively restricted ranges of outcome scores due to the healthy nature of the participants, results may underestimate actual predictive relationships.
PMCID: PMC3412748  PMID: 22738068
Stress disorders, Post-traumatic; Conditioning; Startle; Imagery; Psychophysiology; Risk factors
6.  Physiological Predictors of Posttraumatic Stress Disorder 
Journal of Traumatic Stress  2010;23(6):775-784.
Studies have assessed relationships between posttraumatic stress disorder (PTSD) symptoms and physiological reactivity concurrently; fewer have assessed these relationships longitudinally. This study tests concurrent and prospective relationships between physiological reactivity (heart rate and skin conductance) to a monologue procedure and PTSD symptoms in female assault survivors, tested within 1 and 3 months posttrauma. After controlling for initial PTSD and peritraumatic dissociation, 3 measures of increased physiological reactivity to the trauma monologue at 1 month predicted 3-month PTSD reexperiencing severity. Additionally, increased heart rate following trauma and neutral monologues at 1 month was predictive of 3-month numbing symptoms. Implications for the prospective relationship between physiological reactivity to trauma cues and PTSD over time are discussed.
PMCID: PMC3336199  PMID: 21171139
7.  An alternative scoring method for skin conductance responding in a differential fear conditioning paradigm with a long-duration conditioned stimulus 
Psychophysiology  2009;46(5):984-995.
Researchers examining skin conductance (SC) as a measure of aversive conditioning commonly separate the SC response into two components when the CS-UCS interval is sufficiently long. This convention drew from early theorists who described these components, the first- and second-interval responses, as measuring orienting and conditional responses, respectively. The present report critically examines this scoring method through a literature review and a secondary data analysis of a large-scale study of police and firefighter trainees that used a differential aversive conditioning procedure (n = 287). The task included habituation, acquisition, and extinction phases, with colored circles as the CSs and shocks as the UCS. Results do not support the convention of separating the SC response into first- and second-interval responses. It is recommended that SC response scores be derived from data obtained across the entire CS-UCS interval.
PMCID: PMC2868319  PMID: 19558401
Conditioning; Electrodermal response (skin electric response); Scoring methods
8.  Personality and fear responses during conditioning: Beyond extraversion 
The personality domain of introversion-extraversion has been theorized to be associated with the strength of fear conditioning, but the literature on this topic has been equivocal. Furthermore, except for extraversion and neuroticism, relationships of the other Big Five personality domains with fear response acquisition have not been explored. In the current study, multi-level modeling was used to examine the relationships of facets of the Big 5 domains to fear response acquisition. Participants were 217 police and firefighter trainees who completed the Revised NEO Personality Inventory (NEO-PI-R; Costa & McCrae, 1992) and a fear conditioning task as part of a larger study. Results indicated that several facets of extraversion have opposing associations with fear response acquisition of an electrodermal response– possibly contributing to the mixed results in the literature. Additionally, facets of other Big Five domains were found to be associated with fear response acquisition.
PMCID: PMC2598742  PMID: 20046207
fear conditioning; Big 5; personality; extraversion; neuroticism; multi-level modeling; psychophysiology

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