(PS13-95) Examining the Predictive Role of Attentional Fluctuation in Posttraumatic Stress Symptom Severity at 6 Months Following Traumatic Events

Cognitive models propose that attentional bias (AB) towards threat cues plays a role in maintaining posttraumatic stress disorder (PTSD) symptoms (Bar-Haim et al., 2007). More recent studies view AB as a dynamic process (Zvielli et al., 2014), and heightened temporal dynamics in AB have been associated with PTSD symptoms (Iacovielle et al., 2014; Naim et al., 2015). Notably, a longitudinal study demonstrated that greater attentional fluctuation (AF) predicted posttraumatic symptoms in deployed soldiers (Schäfer et al., 2016), suggesting a predictive role of AF in PTSD symptoms. However, it is unknown whether increased AF following trauma predicts the severity of PTSD symptoms over time. This study aimed to replicate and extend these findings by examining the predictive role of AF change on PTSD symptom severity in individuals exposed to diverse traumatic events.

As part of a larger longitudinal study that examined various psychological and neurobiological aspects of PTSD symptoms, the current study included 127 participants who recently exposed to trauma (e.g., motor vehicle crash, assault) (Mean age = 32.41, Female 55.1%; Black and African American 53.5%, White 30.7%). Participants completed self-report measures, such as PTSD Checklist for DSM-5 (PCL-5) and Depression Anxiety Stress Scale-21 (DASS21) at 2 weeks, 3 months, and 6 months after the traumatic event. Additionally, a dot-probe task was administered at 2 weeks and 6 months. During the dot-probe task, a pair of neutral-trauma or neutral-neutral words were presented after a fixation cross disappeared. Participants were asked to press a key (e.g., e or f) depending on the cue. AB indices were computed using conventional methods and a recently developed AF methodology (Zvielli et al., 2014). A hierarchical regression analysis examined whether the changes in AF and AB predicted PTSD symptoms at 6 months after controlling for demographic features and general emotional distress (DASS-21).

The hierarchical regression model revealed significant findings in predicting PTSD symptoms at the 6-month follow-up. The initial model, including age, gender, PCL-5 scores, and DASS21 scores, was statistically significant (Adjusted R² = .398, F(6, 110) = 13.79, p < 0.001). Notably, the PCL-5 score at 3 months emerged as a significant predictor (β = 0.376, p = 0.028), significantly contributing to the model. The expanded model demonstrated improved explanatory power (Adjusted R² = .428, F(4, 108) = 3.88, p = 0.024). The results showed that the change in AF from 2week to 6months (β = 2.748, p = 0.007) made significant contributions, indicating potential impact of worsened AF following trauma on PTSD symptoms at the 6-month follow-up. Changes in the AB index were not predictive of PTSD symptoms.

This study replicates prior research on the temporal dynamics of AB and PTSD symptoms, suggesting that unstable attentional processes may better predict PTSD symptom severity than static attentional bias. This aligns with findings indicating that attentional control training may be more beneficial than attentional bias modification (Amy et al., 2015). The current findings support the need for an intervention aimed at reducing unstable attentional dynamics in order to prevent the development of PTSD.