Abstract
In the presence of threatening stimuli, post-traumatic stress disorder (PTSD) can manifest as hypervigilance for threat and disrupted attentional control. PTSD patients have shown exaggerated interference effects on tasks using trauma-related or threat stimuli. In studies of PTSD, faces with negative expressions are often used as threat stimuli, yet angry and fearful facial expressions may elicit different responses. The modified Eriksen flanker task, or the emotional face flanker, has been used to examine response interference. We compared 23 PTSD patients and 23 military controls on an emotional face flanker task using angry, fearful and neutral expressions. Participants identified the emotion of a central target face flanked by faces with either congruent or incongruent emotions. As expected, both groups showed slower reaction times (RTs) and decreased accuracy on emotional target faces, relative to neutral. Unexpectedly, both groups showed nearly identical interference effects on fearful and neutral target trials. However, post hoc testing suggested that PTSD patients showed faster RTs than controls on congruent angry faces (target and flanker faces both angry) relative to incongruent, although this finding should be interpreted with caution. This possible RT facilitation effect with angry, but not fearful faces, also correlated positively with self-report measures of PTSD symptoms. These results suggest that PTSD patients may be more vigilant for, or primed to respond to, the appearance of angry faces, relative to fearful, but further study is needed.
Highlights
Post-traumatic stress disorder (PTSD) involves a constellation of symptoms following trauma exposure, such as re-experiencing of the trauma, hypervigilance for threat and avoidance of trauma reminders (DSM-5, American Psychiatric Association, 2013)
Post hoc testing suggested that PTSD patients showed faster reaction times (RTs) than controls on congruent angry faces relative to incongruent, this finding should be interpreted with caution. This possible RT facilitation effect with angry, but not fearful faces, correlated positively with selfreport measures of PTSD symptoms. These results suggest that PTSD patients may be more vigilant for, or primed to respond to, the appearance of angry faces, relative to fearful, but further study is needed
A significant main effect was shown for Target Valence [F(2,88) = 60.1, p < 0.0001, η2p = 0.58], with pairedt-test comparisons revealing that both groups were slower on emotional target faces, relative to neutral [t(45) = 9.81, p < 0.001, d = 1.45]
Summary
Post-traumatic stress disorder (PTSD) involves a constellation of symptoms following trauma exposure, such as re-experiencing of the trauma, hypervigilance for threat and avoidance of trauma reminders (DSM-5, American Psychiatric Association, 2013). Angry and Fearful Face Conflict in PTSD fear may convey different types of threat and elicit different responses (Davis et al, 2011; Berggren and Derakshan, 2013; Taylor and Whalen, 2014; Woodward et al, 2017). While fear communicates danger in the surroundings (externally oriented for environmental monitoring), anger conveys a more proximal, central and direct threat, focusing attention inward (Davis et al, 2011; Berggren and Derakshan, 2013; Taylor and Whalen, 2014). In an eye-tracking task of initial orienting with high- and low-anxious undergraduates, Mogg et al (2007) found similar patterns of attentional biases for both anger and fearful face expressions. In a forced-choice emotion recognition task with blurred faces directed toward or away from an observer, Hortensius et al (2016) found that anger was better recognized when an expression was directed toward an observer, yet fear was better recognized when directed away from an observer, underscoring the potentially different ecological roles of these expressions
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