DESCRIPTION (provided by applicant): Based on my overarching career goal of becoming a clinical scientist in an academic setting with a program of work focused on understanding the range of emotional reactions associated with traumatic events and their affect on both natural and facilitated recovery from posttraumatic stress reactions, I am seeking training in 1) the use of sophisticated methodological and analytic techniques involving trauma-relevant laboratory elicitation and assessment of emotion; 2) the use of experimental psychopathology methods to understand posttraumatic sequelae, including PTSD; and 3) the application of this evidence to the development and refinement of both treatment and prevention programs targeting problematic posttraumatic outcomes. The proposed laboratory-based study represents a key step in the service of these aims by providing a rich context for me to examine mechanisms that can inform the development of tailored, evidence-based interventions. As such, the proposed study utilizes sophisticated laboratory-based procedures to compare rates of decline in the emotional reactivity of disgust and fear in response to repeated exposure to sexual assault-related cues. Specifically, 92 sexually assaulted women will complete a laboratory-based assessment of disgust- and fear-based emotional reactivity in response to repeated exposures to an individualized script-driven imagery procedure. Change in emotional reactivity will be measured following exposure to disgust- and fear- focused sexual assault scripts as well as neutral scripts (control groups). Participants will be randomly assigned to one of four groups (2 experimental, 2 control) where they will receive repeated exposure to disgust-focused and fear-focused sexual assault scripts (experimental groups) or neutral scripts (control groups). Specific study hypotheses are as follows: 1) overall, repeated exposure to sexual assault cues will result in less extinction of disgust-based reactivity compared to fear-based reactivity, 2) repeated exposure to disgust-focused sexual assault cues, compared to exposure to fear-focused cues, will result in greater extinction of disgust-based reactivity, and 3) Repeated exposure to fear-focused sexual assault cues, compared to exposure to disgust- focused cues, will result in greater extinction of fear-based reactivity. Exposure-based procedures are integrated into the most well-established prevention programs and treatments for posttraumatic stress resulting from sexual assault, yet a significant minority of people receiving such interventions do not appear to benefit and people responding well to interventions commonly report residual symptoms . Accordingly, this project aims to understand specific processes and mechanisms that likely affect outcomes of exposure-based interventions to advance efforts to further alleviate the extensive public health burden introduced by PTSD.
PUBLIC HEALTH RELEVANCE: While leading scholars in the area of sexual assault have long suggested that emotions other than fear are likely to be impact interventions for posttraumatic problems, the current project incorporates one of the first controlled laboratory investigations of this hypothesis by investigating the effects of exposure to sexual assault- relevant cues on disgust- and fear-based reactivity. Findings from this study will lay the foundation for an investigation of effects of specifically targeting disgust-based reactivity in the treatment of sexual assault- related PTSD. This project is both significant and clinically important in that it seeks to better understand specific processes and mechanisms that likely affect outcomes of exposure-based interventions in an effort to enhance interventions designed to alleviate the extensive public health burden introduced by PTSD.