Trauma, attentional dysregulation, and the development of posttraumatic stress: An investigation of risk pathways

Judith Schäfer, Ariel Zvielli, Michael Höfler, Hans Ulrich Wittchen, Amit Bernstein

Research output: Contribution to journalArticlepeer-review


Background: Fundamental questions regarding the nature and function of attentional bias (AB) to threat in the etiology of posttraumatic stress disorder (PTSD) remain unanswered. We tested the temporal interplay between trauma exposure, dysregulated attentional processing of threatening information pre- and post-trauma, and the development of posttraumatic intrusions. Methods: Response time to trauma-related threat, trauma-unrelated threat, as well as to trauma-related but typically emotionally-neutral stimuli was assessed using the dot probe task before and one week after watching a violent movie scene that served as a trauma analogue. AB was analyzed as a dynamic process by means of a recently developed approach indexing momentary fluctuations of AB toward and away from emotional stimuli. Posttraumatic intrusions were measured daily over the week following analogue trauma exposure. Results: We found that key features of AB dynamics to trauma-related stimuli at post-, but not pre-, trauma exposure were associated with posttraumatic intrusions. Notably, these post-trauma exposure effects were specific to biased attentional processing of trauma-related but not threatening stimuli unrelated to the traumatic event. In line with a growing body of findings, pre- and post-trauma exposure traditional aggregated mean AB scores were not similarly associated with posttraumatic intrusions. Conclusions: We conclude that one mechanism through which trauma exposure may contribute to the development of PTSD is through its dysregulation of attentional processing of trauma event-related cues. Future work may focus on delineating the developmental course through which attentional dysregulation post-trauma and posttraumatic intrusions unfold and interact.

Original languageEnglish
Pages (from-to)60-66
Number of pages7
JournalBehaviour Research and Therapy
StatePublished - Mar 2018

Bibliographical note

Funding Information:
This study was funded by funding opportunities for young scientists (Anschubfinanzierung) from the Department of Psychology of the Technische Universität Dresden . Judith Schäfer was funded by a doctoral stipend of the Technische Universität Dresden (Stipendienprogramm zur Förderung von Nachwuchswissenschaftlerinnen). Ariel Zvielli, Michael Höfler and Hans-Ulrich Wittchen have nothing to disclose. Amit Bernstein reports a patent application on a technological system to train attention. Amit Bernstein reports no current or impending commercial or financial conflict of interest or expected gain related to the publication of this study. The study was approved by the TUD Ethics Board (EK 405112011).

Publisher Copyright:
© 2018


  • Attention
  • Attentional bias
  • Cognition
  • Post-traumatic stress disorder
  • Sexual assault
  • Trauma

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Clinical Psychology
  • Psychiatry and Mental health


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