Use of the emotional Stroop to assess psychological trauma following traumatic brain injury

The Role in Road Traffic Accident and Anxiety as Moderators Attention Biases in Modified Emotional Stroop Test

Introduction

According to the World Health Organisation, road accidents will be the most common cause of premature death by 2020. According to research, one in every five victims of accidents suffers from acute stress disorder and one in every four suffers from psychological problems up to 1 year after the event, including post-traumatic stress disorder. It was assumed that one of the mechanisms responsible for maintaining excessive arousal or anxiety is a dysfunction in cognitive processes occurring under the guise of selective attention disorders or a deficit in executive control.

Materials and Methods

The research encompassed 157 individuals (a group of victims and perpetrators N = 90; M = 34.1, SD = 10.77; control group N = 67; M = 34.20, SD = 11.16). The participants, tested after road traffic accidents, were patients of Traumatology and Orthopedic wards in Warsaw who had been involved in a road traffic accident up to a month prior to the research. The state of their physical injuries and administered drugs were monitored so that this did not interfere with the tests the participants undertook on computer. In each situation, the decision was made by the doctor responsible for the patient in the hospital ward. The control group comprised people who drive regularly and in 5 years had not been involved in any road traffic incidents. The participants from both groups completed the State–Trait Anxiety Inventory questionnaire on anxiety as a state and as a trait, as well as a modified computerized emotional Stroop test. This new version of the test enables a study of the process of the depth of coding of the stimuli associated with trauma.

Results

The hypotheses were tested with the use of a series of correlation analyses, regression analyses with a stepwise method of entering predictors into the model, and mediation analyses with the use of the A. F. Hayes PROCESS macro. Differences were observed in the declarative level of anxiety as a state and the size of the interference effect depending on the person’s status in the accident. It was discovered that in the group of perpetrators, the longer the interference effect, the lower the declared level of anxiety as a state and they were significantly worse at remembering the stimuli associated with trauma.

Conclusion

Anxiety symptoms in victims and perpetrators of road traffic accidents measured by self-report questionnaires are consistent only among victims. In the case of perpetrators, an accurate measure of disorders is a study with the use of methods enabling the tracking of the functioning of unconscious processes.

Are neuropsychological deficits after trauma associated with ASD severity?

Acute stress disorder (ASD) is a fairly common sequela of traumatic exposure, and a significant proportion of those with the disorder go on to develop PTSD. Although neuropsychological deficits soon after trauma exposure have been associated with subsequent PTSD onset, few studies have assessed their association with ASD severity. We sought to investigate neuropsychological predictors of ASD severity in a sample of 128 motor vehicle accident (MVA) survivors, while controlling for potential confounders, such as demographic characteristics, other psychiatric diagnoses, and intelligence. We conducted clinical and neuropsychological assessments approximately 10.3 ± 4.5 days after an MVA. Our findings showed that delayed verbal recall was significantly associated with ASD severity, explaining 12.6% of the variance. However, a large proportion of the variance in ASD severity, 13.6%, was also explained by suicide risk. Effect size of the model was moderate (f(2) = 0.171). Suicide risk and delayed verbal recall appear to be moderately associated with ASD severity after a MVA and may be useful indicators of distress in in acute trauma survivors.

Attentional bias and symptoms of posttraumatic stress disorder one year after burn injury

Trauma-related attentional bias is suggested to play a role in maintaining posttraumatic stress disorder (PTSD). Although being burn injured is a traumatic event for many patients, there are no prospective studies investigating attentional bias. The aims were to assess burn-specific attentional bias 1 year after burn, and its associations with risk factors for PTSD and symptoms of PTSD. A total of 38 adult patients with burns were assessed with a structured clinical interview and a Swedish version of the Impact of Event Scale-Revised up to 1-year after burn. The Emotional Stroop Task was used to assess attentional bias 1 year after burn. In total 29 participants displayed burn-specific attentional bias. This group had more previous life events, perceived life threat, larger burns, and higher PTSD symptom severity. In conclusion, the majority of the patients had burn-specific attentional bias 1 year after burn and this was related to symptoms of PTSD.