Abstract
Dysfunctional processing of traumatic events may be in particular related to high trait anxiety as a pre-traumatic risk factor for the development of post-traumatic stress disorder (PTSD). However, as this has rarely been investigated in prospective, experimental studies, we aimed to analyse the association between high trait anxiety and affective as well as cognitive processing of stress using a new prospective Virtual Reality analogue trauma paradigm to overcome limitations of retrospective or current analogue designs. Individuals with high and low trait anxiety (N = 80) were exposed to a multi-sensory Virtual Reality emergency scenario while psychophysiological stress response, emotion regulation and intrusive memories were assessed. Our results showed that high trait anxiety individuals display increased (i) subjective stress responses, (ii) emotion dysregulation and (iii) intrusive memories upon VR analogue trauma exposure. In particular, our sample of high trait anxiety individuals displayed limited access to different emotion regulation strategies as well as increased worry and rumination regarding perceived intrusive memories. Considering the complex interplay of multiple risk factors, our findings suggests that peri-traumatic affective processing seems to mediate high trait anxiety and post-traumatic intrusive memories thereby pointing out the central role of peri-traumatic processes for intrusion development. In addition, HA as a modulating pre-traumatic risk factor might further increase the risk of later dysfunctional processing of an analogue trauma by interacting with factors of affective processing during analogue trauma exposure. Implications of these findings which may contribute to a higher risk to develop PTSD are discussed.
Highlights
Intense peri-traumatic negative emotions which we have found in our study are considered a natural first stress response upon confrontation with a potentially traumatic event [4,17], increased peri-traumatic anxiety is associated with a higher risk of developing stress-associated symptoms [14] as well as higher peri-traumatic stress is associated with an increased risk to develop post-traumatic stress disorder (PTSD) [63]
The Virtual Reality (VR) analogue trauma paradigm may contribute to prevent stress-associated disorders in the future by interventions targeting peri- and post-traumatic risk factors in real-time. This is the first study to investigate the complex interplay of multiple risk factors in stress processing in a prospective VR analogue trauma paradigm
Our findings suggest that high trait anxiety (HA) contributes to dysfunctional affective and cognitive processing of a VR analogue trauma
Summary
Common initial stress responses following traumatic events are fear, helplessness, horror and subsequent involuntary intrusive memories [4,5]. While this initial stress response is only temporarily for most people [6], others fail to recover and develop stress-associated disorders such as post-traumatic stress disorder (PTSD), anxiety disorders, depression or substance abuse [7,8]. One key factor in this context might be individual differences in stress processing [9,10]. The aim of the current study was to explore the impact of individual differences in trait anxiety on affective and cognitive processing of an analogue trauma
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