Attentional interference by threat and post-traumatic stress disorder: The role of thought control strategies

Abstract

Attentional interference by threat is associated with PTSD, but the mechanisms of this relationship remain unclear. Attentional interference might be related to increased use of maladaptive thought control strategies, such as suppressing unwanted thoughts (thought suppression) or replacing threatening thoughts with everyday concerns (worry), which increase PTSD risk. Conversely, attentional interference might be associated with reduced use of adaptive strategies, such as talking about threatening thoughts (social control), which decrease PTSD risk. This study tested if thought control strategies mediate the relationship between attentional interference and PTSD. Sixty-one male Vietnam-era veterans completed measures of PTSD symptoms and thought control strategies. Participants also completed a Visual Search Task measuring attentional interference, which required participants to identify a target letter string among a group of threat or neutral words. Attentional interference by threat was related to PTSD symptoms, and mediation analyses revealed significant indirect effects of attentional interference through thought suppression and worry. Attentional interference was related to re-experiencing and avoidance, but not hyperarousal, symptom clusters. Thought suppression was a unique mediator for re-experiencing, whereas thought suppression and worry both mediated the relationship with avoidance. These results offer evidence for maladaptive thought control strategies as a mechanism linking attentional biases for threat to PTSD.

Keywords:

• Attention
• PTSD
• Information processing bias
• Thought control
• Thought suppression

Notes

¹ We ran exploratory analyses examining the relationship between facilitation of attention towards threat and each of the PTSD symptom clusters, to ensure that the null results found by Pineles and colleagues (2007) were not due to a failure to separate out hyperarousal symptoms. Facilitation of attention was not related to any of the symptom clusters, even hyperarousal (βs < 0.005, ts < 1, ns).

Additional information

Funding

These data were collected as part of a larger study (Pineles, Shipherd, Welch, & Yovel, 2007). BEW was supported by Award Number T32MH019836 from the National Institute of Mental Health. SLP was supported by a VA Career Development Award from the Department of Veterans Affairs. JCS was supported by grant W81XWH-09-1-0535 from the US Army Medical Research Unit – Europe. BPM was supported by grants W81XWH-08-2-0028 and W81XWH-08-2-0100 from the US Army Medical Research and Material Command. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veteran Affairs, National Centre for PTSD, National Institute of Mental Health, or the National Institutes of Health.