Project Summary/Abstract
Posttraumatic stress disorder (PTSD) affects a sizeable proportion of the American population and is
associated with severe psychological suffering and impairment. Evidence suggests that individuals with PTSD
have an impairment in attention in the presence of threat information, often described as an attentional bias for
threat. It is thought that this attentional bias serves to maintain and exacerbate PTSD symptoms. While a
bottom-up (i.e., more automatic, sensory-driven) attentional bias to threat has been studied extensively in
PTSD, relatively little is known about the role of top-down (i.e., more controlled, effortful, and goal-directed)
attentional processes in this line of research. Theory and preliminary evidence suggests that attentional control
processes (inhibition, shifting, working memory updating) may be used to override bottom-up, or more reactive
attentional bias to threat. Thus, these cognitive processes may be used to alleviate trauma-related distress in
the short-term, and perhaps, over longer periods of time as well. The proposed study will utilize innovative
translational research methods to elucidate the cross-sectional and prospective roles that top-down cognitive
processes play in threat-related attentional bias in PTSD. The use of three assessment sessions, over the
course of one year, will allow us to determine the degree to which the use of these cognitive processes to
regulate threat-related attentional biases is adaptive over a prolonged period of time. Moreover, we will remedy
several limitations of previous research by (a) using state-of-the-art eye-tracking equipment to provide a
reliable continuous measurement of attentional biases, (b) measuring the specific components of attentional
control via behavioral tasks, and (c) examining both positive and negative emotionally arousing images. Adult
participants (2 groups [Trauma-exposed Control and PTSD]) will complete a battery of self-report
questionnaires, an eye tracking task, and a comprehensive battery of behavioral measures assessing multiple
domains of effortful cognitive processes at a single laboratory session. Additionally, participants will complete
all of the self-report measures administered at the laboratory session at two follow-up sessions, six and twelve
months after the laboratory session. This study is innovative in that it seeks to examine the interactive effect of
top-down and bottom-up attentional processes in order to explicate the nature of threat-related attentional
biases in PTSD. This innovative approach, using objective behavioral measures of top-down cognitive
processes in combination with eye-tracking equipment, may greatly advance our understanding of the complex
nature of threat biases in PTSD, provide more accurate predictions of vulnerability for experiencing prolonged
PTSD symptoms, and have important treatment implications. Specifically, identifying the specific cognitive
processes that modulate this threat bias may result in the development of clinical interventions that directly
target these processes in the service of alleviating trauma-related distress.