Attention biases in female survivors of chronic interpersonal violence: relationship to trauma-related symptoms and physiology

Background Exposure to chronic interpersonal violence (IPV) has been associated with psychiatric impairment; however, few studies have investigated attention processes and psychophysiology in this population. Objective We investigated self-report and physiological correlates of attention biases in 27 IPV-exposed women. Method Participants completed self-report measures of trauma history, posttraumatic stress disorder (PTSD) symptoms, and dissociation; were monitored physiologically during baseline; and responded to an emotional dot probe task. Results Participants showed bias away from positive and anxiety words, and toward IPV words. Lower baseline respiratory sinus arrhythmia (RSA) and higher skin conductance levels were associated with bias away from anxiety cues. Greater total PTSD symptoms were associated with bias toward IPV cues, and greater PTSD intrusion and avoidance symptoms were associated with lower RSA. Individuals exposed to more types of trauma had lower heart rates. Conclusions These data extend the research on emotion–cognition interactions in PTSD and other anxiety disorders to chronic IPV survivors, in part confirming avoidance and intrusion symptom and attention bias relations found in studies. The present work also draws attention to a group that tends to experience a range of severe symptoms associated with apparent blunting in autonomic activity, and suggests that self-report may not be sensitive to physiological and attention alterations in chronic IPV samples.

[1]  D. Nutt,et al.  Autonomic dysregulation and the Window of Tolerance model of the effects of complex emotional trauma , 2011, Journal of psychopharmacology.

[2]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[3]  A. Ohman,et al.  "Unconscious anxiety": phobic responses to masked stimuli. , 1994, Journal of abnormal psychology.

[4]  B. A. van der Kolk,et al.  Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. , 2005, Journal of traumatic stress.

[5]  Lars-Göran Öst,et al.  Attentional and memory bias for emotional information in crime victims with acute posttraumatic stress disorder (PTSD). , 2002, Journal of anxiety disorders.

[6]  Julian F. Thayer,et al.  Autonomic characteristics of generalized anxiety disorder and worry , 1996, Biological Psychiatry.

[7]  H. Irwin,et al.  The effect of emotional context on cognitive inhibition and attentional processing in dissociative identity disorder. , 2005, Behaviour research and therapy.

[8]  E. Gordon,et al.  Arousal Dissociates Amygdala and Hippocampal Fear Responses: Evidence from Simultaneous fMRI and Skin Conductance Recording , 2001, NeuroImage.

[9]  T. Dalgleish,et al.  An experimental investigation of hypervigilance for threat in children and adolescents with post-traumatic stress disorder , 2001, Psychological Medicine.

[10]  J T Cacioppo,et al.  Cardiac psychophysiology and autonomic space in humans: empirical perspectives and conceptual implications. , 1993, Psychological bulletin.

[11]  P. Resick,et al.  Objective assessment of peritraumatic dissociation: psychophysiological indicators. , 1997, The American journal of psychiatry.

[12]  C. MacLeod,et al.  Attentional bias in emotional disorders. , 1986, Journal of abnormal psychology.

[13]  M. Kozak,et al.  Processing of threat-related information in rape victims. , 1991, Journal of abnormal psychology.

[14]  Martin H. Teicher,et al.  PROPOSAL TO INCLUDE A DEVELOPMENTAL TRAUMA DISORDER DIAGNOSIS FOR CHILDREN AND ADOLESCENTS IN DSM-V , 2009 .

[15]  M. Eysenck,et al.  Attentional bias to threat in clinical anxiety states , 1992 .

[16]  Joshua R. Shumen,et al.  Aversive Imagery in Posttraumatic Stress Disorder: Trauma Recurrence, Comorbidity, and Physiological Reactivity , 2010, Biological Psychiatry.

[17]  John L. Andreassi,et al.  Psychophysiology: Human Behavior & Physiological Response , 2000 .

[18]  S. Filipović,et al.  Psychophysiology: Human Behavior and Physiological Response (4th ed.) , 2001 .

[19]  R. Kessler,et al.  Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. , 1998, Archives of general psychiatry.

[20]  Kenneth J. Ruggiero,et al.  Psychometric Properties of the PTSD Checklist—Civilian Version , 2003, Journal of traumatic stress.

[21]  J. Andreassi Psychophysiology: Human Behavior and Physiological Response , 1980 .

[22]  U. Schnyder,et al.  Impact of emotion on cognition in trauma survivors: what is the role of posttraumatic stress disorder? , 2010, Journal of affective disorders.

[23]  Paul Grossman,et al.  Respiratory and cardiac rhythms as windows to central and autonomic biobehavioral regulation: Selection of window frames, keeping the panes clean and viewing the neural topography , 1992, Biological Psychology.

[24]  D. Charney,et al.  Attention bias away from threat during life threatening danger predicts PTSD symptoms at one‐year follow‐up , 2011, Depression and anxiety.

[25]  A. Rusu,et al.  Attention Bias to Threat in Anxiety-Prone Individuals , 2012 .

[26]  D. Charney,et al.  The development of a Clinician-Administered PTSD Scale , 1995, Journal of traumatic stress.

[27]  S. Scott Multiple Traumatic Experiences and the Development of Posttraumatic Stress Disorder , 2007, Journal of interpersonal violence.

[28]  E. Carlson,et al.  An update on the Dissociative Experiences Scale. , 1993 .

[29]  B. Braun,et al.  Psychometric Properties of the Dissociative Experiences Scale , 1995, The Journal of nervous and mental disease.

[30]  E. Hazlett,et al.  The relationship between skin conductance orienting and the allocation of processing resources. , 1991, Psychophysiology.

[31]  O. Hart,et al.  Dissociation: An insufficiently recognized major feature of complex posttraumatic stress disorder. , 2005, Journal of traumatic stress.

[32]  N G Waller,et al.  The prevalence and biometric structure of pathological dissociation in the general population: taxometric and behavior genetic findings. , 1997, Journal of abnormal psychology.

[33]  M. Sack,et al.  Low respiratory sinus arrhythmia and prolonged psychophysiological arousal in posttraumatic stress disorder: heart rate dynamics and individual differences in arousal regulation , 2004, Biological Psychiatry.

[34]  J. Thayer,et al.  Heart Rate Variability, Prefrontal Neural Function, and Cognitive Performance: The Neurovisceral Integration Perspective on Self-regulation, Adaptation, and Health , 2009, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[35]  R. Yerkes,et al.  The relation of strength of stimulus to rapidity of habit‐formation , 1908 .

[36]  G. Sartory,et al.  Attention, heart rate, and startle response during exposure to trauma-relevant pictures: a comparison of recent trauma victims and patients with posttraumatic stress disorder. , 2004, Journal of abnormal psychology.

[37]  F. Esposito,et al.  Amygdala Deactivation as a Neural Correlate of Pain Processing in Patients with Borderline Personality Disorder and Co-Occurrent Posttraumatic Stress Disorder , 2009, Biological Psychiatry.

[38]  Erin B. McClure-Tone,et al.  Attention Bias in Adult Survivors of Childhood Maltreatment with and without Posttraumatic Stress Disorder , 2011, Cognitive Therapy and Research.

[39]  B. Stamm Measurement of stress, trauma, and adaptation , 1996 .

[40]  N. Pole,et al.  The psychophysiology of posttraumatic stress disorder: a meta-analysis. , 2007, Psychological bulletin.

[41]  B. Green,et al.  Disorders of Extreme Stress (DESNOS) Symptoms Are Associated With Type and Severity of Interpersonal Trauma Exposure in a Sample of Healthy Young Women , 2006, Journal of interpersonal violence.

[42]  E. Petkova,et al.  A developmental approach to complex PTSD: childhood and adult cumulative trauma as predictors of symptom complexity. , 2009, Journal of traumatic stress.

[43]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[44]  M. Bradley,et al.  Affective Norms for English Words (ANEW): Instruction Manual and Affective Ratings , 1999 .

[45]  Karin Mogg,et al.  BRIEF REPORT Time course of attentional bias for threat scenes: Testing the vigilance‐avoidance hypothesis , 2004 .

[46]  G. Crombez,et al.  Selective attention to threat in the dot probe paradigm: differentiating vigilance and difficulty to disengage. , 2004, Behaviour research and therapy.

[47]  R. Lanius,et al.  Assessment of anhedonia in psychological trauma: development of the Hedonic Deficit and Interference Scale , 2012, European journal of psychotraumatology.

[48]  J. Thayer,et al.  Vagal influence on working memory and attention. , 2003, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[49]  Scott T. Grafton,et al.  Amygdala activity related to enhanced memory for pleasant and aversive stimuli , 1999, Nature Neuroscience.

[50]  B. Penninx,et al.  Longitudinal Evidence for Unfavorable Effects of Antidepressants on Heart Rate Variability , 2010, Biological Psychiatry.

[51]  Carlo Schuengel,et al.  The measurement of dissociation in normal and clinical populations. Meta-analytic validation of the dissociative experiences scale (des) , 1996 .

[52]  R A Bryant,et al.  Attentional bias in posttraumatic stress disorder. , 1997, Journal of traumatic stress.

[53]  B. A. van der Kolk,et al.  Preliminary evidence of parasympathetic influence on basal heart rate in posttraumatic stress disorder. , 2006, Journal of psychosomatic research.

[54]  K. Felmingham,et al.  Eye tracking and physiological reactivity to threatening stimuli in posttraumatic stress disorder. , 2011, Journal of anxiety disorders.

[55]  N. Pole,et al.  A naturalistic study of the relation of psychotherapy process to changes in symptoms, information processing, and physiological activity in complex trauma. , 2012 .

[56]  B. Teachman,et al.  Information processing biases and panic disorder: relationships among cognitive and symptom measures. , 2007, Behaviour research and therapy.

[57]  Murray B. Stein,et al.  Imbalance of Approach and Avoidance: The Yin and Yang of Anxiety Disorders , 2009, Biological Psychiatry.

[58]  F. Weathers Psychometric Properties of Nine Scoring Rules for the Clinician Administered Posttraumatic Stress Disorder Scale , 2001 .

[59]  Eric Granholm,et al.  Pupillary and reaction time measures of sustained processing of negative information in depression , 2001, Biological Psychiatry.

[60]  S. Porges The polyvagal perspective , 2007, Biological Psychology.