Attention control therapy for acute stress disorder: A randomized controlled trial

Is attentional bias variability causally implicated in emotional vulnerability? A systematic review and meta-analysis

BACKGROUND

The aim of the present review was to determine whether attentional bias variability (ABV) is causally implicated in emotional vulnerability. We consider evidence examining whether ABV precedes and predicts later psychopathology, and whether modifying ABV leads to changes in psychological symptoms following an intervention.

METHODS

A systematic literature search located 15 studies that met the inclusion criteria (3 longitudinal, 12 intervention). Eligible intervention studies were also meta-analysed.

RESULTS

Preliminary evidence suggests that ABV predicts later post-traumatic stress symptomatology in interaction with number of traumatic events. The few interventions designed to reduce ABV suggest promise for improving PTSD symptoms. However, these interventions did not consistently change ABV, and where it was tested, change in ABV did not correspond to change in symptoms.

CONCLUSIONS

There is emerging evidence that ABV could represent a vulnerability factor for psychological symptoms, particularly for those exposed to trauma. This may indicate attentional control difficulties, although this remains to be tested. Conclusions regarding the causal status of ABV will depend on future high-quality randomised controlled trials.

Cognitive Bias Modification bei Symptomen der Posttraumatischen Belastungsstörung

Kognitive Modelle der Posttraumatischen Belastungsstörung (PTBS) gehen davon aus, dass eine dysfunktionale Informationsverarbeitung in den Bereichen Aufmerksamkeit, Interpretation, Bewertung und Gedächtnis einen wichtigen Faktor für das Auftreten und die Aufrechterhaltung der PTBS darstellt. Parallel zeigen verschiedenste Entwicklungen in der klinisch-experimentellen Forschung, dass es möglich sein könnte, solche kognitiven Verzerrungen mithilfe von Cognitive Bias Modification (CBM)-Trainings zu modifizieren. In diesem Beitrag geben wir einen narrativen Überblick über die CBM-Forschung im Kontext von Trauma und PTBS, im experimentellen sowie klinisch-angewandten Bereich. Zudem werden Herausforderungen und neue Forschungslinien für die CBM-Forschung im Kontext der PTBS vorgestellt und diskutiert.

A critical review of mechanisms of adaptation to trauma: Implications for early interventions for posttraumatic stress disorder

Although many attempts have been made to limit development of posttraumatic stress disorder (PTSD) by early intervention after trauma exposure, these attempts have achieved only modest success. This review critiques the biological and cognitive strategies used for early intervention and outlines the extent to which they have prevented PTSD. The major predictors of PTSD are reviewed, with an emphasis on potential mechanisms that may underpin the transition from acute stress reaction to development of PTSD. This review highlights that there is a wide range of biological and cognitive factors that have been shown to predict PTSD. Despite this, the major attempts at early intervention have focused on strategies that attempt to augment extinction processes or alter appraisals in the acute period. The documented predictors of PTSD indicate that a broader range of potential strategies could be explored to limit PTSD. The evidence that people follow different trajectories of stress response following trauma and there is a wide array of acute predictors of PTSD indicates that a flexible and tailored approach needs to be investigated to evaluate more effective early intervention strategies.