Article

Attentional bias for trauma-related words: exaggerated emotional Stroop effect in Afghanistan and Iraq war veterans with PTSD

BMC Psychiatry (Impact Factor: 2.24). 03/2013; 13(1):86. DOI: 10.1186/1471-244X-13-86
Source: PubMed

ABSTRACT Background
Post-traumatic stress disorder (PTSD) involves debilitating symptoms that can disrupt cognitive functioning. The emotional Stroop has been commonly used to examine the impact of PTSD on attentional control, but no published study has yet used it with Afghanistan and Iraq war veterans, and only one previous study has compared groups on habituation to trauma-related words.

Methods
We administered the emotional Stroop, the Beck Depression Inventory (BDI), and the PTSD Checklist (PCL) to 30 veterans with PTSD, 30 military controls, and 30 civilian controls. Stroop word types included Combat, Matched-neutral, Neutral, Positive and Negative.

Results
Compared to controls, veterans with PTSD were disproportionately slower in responding to Combat words. They were also slower and less accurate overall, did not show interference on Negative or Positive words relative to Neutral, and showed a trend for delayed but successful habituation to Combat words. Higher PCL and BDI scores also correlated with larger interference effects.

Conclusions
Because of its specificity in detecting attentional biases to trauma-related words, the emotional Stroop task may serve as a useful pre- and post task with intervention studies of PTSD patients.

Download full-text

Full-text

Available from: Victoria Ashley, Jun 25, 2014
1 Follower
 · 
164 Views
 · 
20 Downloads
  • Source
    • "However, several investigations have reported that such pathological differences have not been observed in replications with PTSD in combat veterans most likely due to the lack of a personally relevant stimuli for combateexposed veterans (Amdur, Larsen, & Liberzon, 2000; Wolf, Miller, & McKinney, 2009). In addition, evidence gathered from U.S. war veterans diagnosed with PTSD shows pathological differences in attentional bias using an Emotional Stroop task emerge with regard to processing of traumarelated words only when distractors were combat-related, as compared to other negative distractors (Ashley et al., 2013; for an alternative explanation see Iacoviello et al., 2014). A strong demand for emotion research in military populations currently exists, with estimates of PTSD at 13.8% among U.S. soldiers returning from deployments to Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) (Tanielian & Jaycox, 2008). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Emotionally relevant pictorial stimuli utilized in studies to characterize both normal and pathological emotional responses do not include military scenarios. Failures to replicate consistent findings for military populations have led to speculation that these image sets do not capture personally relevant experiences. The Military Affective Picture System (MAPS) was developed consisting of 240 images depicting scenes common among military populations. A Self-Assessment Manikin was administered to a 1) U.S. Army soldiers and a 2) non-military population. Findings revealed gender differences in valence and dominance dimensions, but not arousal, for both samples. Valence scores were higher for the military. Arousal ratings decrease as a product of combat exposure. Civilian females demonstrated stronger correlations of valence and arousal when viewing positive or negative images. Given the limited power achieved in the current studies' gender comparisons; it would be difficult to draw major conclusions regarding the interaction of combat exposure or military status with gender for each of the categories. Without having included the IAPS ratings for comparison it is difficult to conclude whether effects only pertain to viewing MAPS images, or if there was unintentional selection bias. Additional ratings would provide better assessments for these effects in both males and females. The MAPS has potential as a screening instrument and clinical evaluation tool for assessing treatment outcomes for individuals with combat-related psychopathology. The MAPS is freely available for research to non-profit groups upon request at http://www.cla.auburn.edu/psychology/military-affective-picture-system/. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Journal of Behavior Therapy and Experimental Psychiatry 08/2015; 50:152-161. DOI:10.1016/j.jbtep.2015.07.006 · 2.23 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The stability of cognitive control processes over time can be indexed by trial-to-trial variability in reaction time (RT). Greater RT variability has been interpreted as an indicator of executive dysfunction, inhibitory inefficiency, and excessive mental noise. Previous studies have demonstrated that combat veterans with post-traumatic stress disorder (PTSD) show substantial impairments in inhibitory control, but no studies have examined response variability in this population. In the current experiment, RT variability in the Go/NoGo response inhibition task was assessed for 45 veterans with PTSD and 34 control veterans using the intra-individual coefficient of variation (ICV) and ex-Gaussian analysis of RT distributions. Despite having mean RTs that were indistinguishable from controls, the PTSD patients had significantly greater RT variability as measured by ICV. More variable RTs were in turn associated with a greater number of false alarm errors in the patients, suggesting that less consistent performers were less successful at inhibiting inappropriate responses. RT variability was also highly correlated with self-reported symptoms of PTSD, depression, and attentional impulsiveness. Furthermore, response variability predicted diagnosis even when controlling for PTSD symptom severity. In turn, PTSD severity was correlated with self-rated attentional impulsiveness. Deficits in the top-down cognitive control processes that cause greater response variability might contribute to the maintenance of PTSD symptomology. Thus, the distractibility issues that cause more variable reaction times might also result in greater distress related to the trauma.
    Neuropsychologia 10/2013; 51(14). DOI:10.1016/j.neuropsychologia.2013.10.008 · 3.45 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite the established evidence for threat-related attention bias in anxiety, the mechanisms underlying this bias remain unclear. One important unresolved question is whether disorder-congruent threats capture attention to a greater extent than do more general or disorder-incongruent threat stimuli. Evidence for attention bias specificity in anxiety would implicate involvement of previous learning and memory processes in threat-related attention bias, whereas lack of content specificity would point to perturbations in more generic attention processes. Enhanced clarity of mechanism could have clinical implications for the stimuli types used in Attention Bias Modification Treatments (ABMT). Content specificity of threat-related attention bias in anxiety and potential moderators of this effect were investigated. A systematic search identified 37 samples from 29 articles (N = 866). Relevant data were extracted based on specific coding rules, and Cohen's d effect size was used to estimate bias specificity effects. The results indicate greater attention bias toward disorder-congruent relative to disorder-incongruent threat stimuli (d = 0.28, p < 0.0001). This effect was not moderated by age, type of anxiety disorder, visual attention tasks, or type of disorder-incongruent stimuli. No evidence of publication bias was observed. Implications for threat bias in anxiety and ABMT are discussed.
    Clinical Psychology Review 11/2014; 35. DOI:10.1016/j.cpr.2014.10.005 · 7.18 Impact Factor
Show more