Abstract

Convergent evidence supports a crucial role for dysfunctional appraisals in the development and maintenance of post-traumatic stress disorder (PTSD). However, most research in this area has used self-report measures, assessing only explicit forms of such negative cognitions; the relevance of their more automatically-activated counterparts, as assumed by cognitive models, remains relatively unexplored. The current study aimed to further our understanding of the potential utility of measuring automatic dysfunctional associations in the context of posttraumatic stress. The relationship between scores on two different implicit association tests (IATs) and posttraumatic stress symptoms was investigated in a sample of adults (N = 279) who reported having experienced a potentially traumatic negative life event. Participants completed the two IATs (one assessing self-traumatized associations, the other self-vulnerable associations), a self-report measure of dysfunctional appraisals, and measures of posttraumatic stress symptoms and other aspects of psychopathology online. Scores indicating higher levels of dysfunctional associations on both IATs were associated with higher levels of posttraumatic stress symptoms. Only scores on the IAT measuring self-vulnerable associations, and not the IAT measuring self-traumatized associations, continued to show an association with posttraumatic stress symptoms after controlling for explicit dysfunctional appraisals. Overall, the results indicate the value of investigating PTSD-relevant automatic associations to further develop our understanding of cognitive processes implicated in posttraumatic stress.

Highlights

  • Many people will experience a traumatic event in their lifetime, for example 60.7% of men 51.2% of women in the US National Comorbidity survey (Kessler et al, 1995), the extent to which this causes them lasting distress varies greatly: Some people will experience no impact beyond the short-term, while at the other end of the spectrum others will experience prolonged distress and functional impairment

  • An RCT amongst inpatients with post-traumatic stress disorder (PTSD) found that reducing dysfunctional appraisals directly via computerized training was associated with reductions in PTSD symptoms (Woud et al, 2021)

  • This study investigated two different implicit associations tests (IATs) as potential indirect measures of post-traumatic stress disorder (PTSD)-relevant cognitions

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Summary

Participants and Recruitment

Participants were recruited via PsyWeb (https://psyweb.uni-muenster.de/), a non-commercial online panel for individuals from the general population who are interested in taking part in psychological research. Inclusion criteria were being aged 18 or over, and reporting having experienced a distressing negative life event (cf Woud et al, 2019a). A total of 518 participants provided consent, and of these 420 provided details of a distressing or traumatic life event. A further 342 completed the first part of the study (both IATs and details of trauma), with 281 completing the rest of the survey (all questionnaires). All remaining participants were included in the analyses with no further exclusions. This left a final data set of 279 participants (189, 67.74%, female). No additional inclusion/ exclusion criteria were applied based on participants’ patterns of responding on the IAT. No financial incentives or other compensation were provided for participation

Design and Procedure
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