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

BMC Psychiatry (Impact Factor: 2.21). 03/2013; 13(1):86. DOI: 10.1186/1471-244X-13-86
Source: PubMed


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.

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.

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.

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


Available from: Timothy Justus, Oct 31, 2015
  • Source
    • " to emotional stimuli ( processing word content instead of solving the main task of reporting ink color ) . The emotional Stroop task has been used successfully with patients with panic disorder ( Dresler et al . , 2012 ) , specific phobia ( Wikstrom et al . , 2004 ) , social phobia ( Andersson et al . , 2006 ) , post - traumatic stress disorder ( Ashley et al . , 2013 ) , generalized anxiety disorder ( Mogg and Bradley , 2005 ) , health anxiety ( Karademas et al . , 2008 ) , etc . In non - clinical populations , the largest emotional Stroop effects are usually observed for those stimuli that relate to the participants ' current concerns , such as for dentist - related words for people showing anxiety"
    [Show abstract] [Hide abstract]
    ABSTRACT: Attentional bias toward threatening or emotional information is considered a cognitive marker of anxiety, and it has been described in various clinical and subclinical populations. This study used an emotional Stroop task to investigate whether math anxiety is characterized by an attentional bias toward math-related words. Two previous studies failed to observe such an effect in math-anxious individuals, although the authors acknowledged certain methodological limitations that the present study seeks to avoid. Twenty high math-anxious (HMA) and 20 low math-anxious (LMA) individuals were presented with an emotional Stroop task including math-related and neutral words. Participants in the two groups did not differ in trait anxiety or depression. We found that the HMA group showed slower response times to math-related words than to neutral words, as well as a greater attentional bias (math-related – neutral difference score) than the LMA one, which constitutes the first demonstration of an attentional bias toward math-related words in HMA individuals.
    Full-text · Article · Nov 2015 · Frontiers in Psychology
  • 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 Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Aug 2015 · Journal of Behavior Therapy and Experimental Psychiatry
  • [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.
    No preview · Article · Oct 2013 · Neuropsychologia
Show more