Linking attentional control and PTSD symptom severity: the role of rumination

Experiencing trauma is quite common in the general population; in fact, about 50% of the population will experience a traumatic event in their lifetime. Experiencing symptoms of posttraumatic stress disorder (PTSD) following a trauma is likewise very common; however, the persistence of these symptoms is less common, and only about 10-20% of those who experience a trauma go on to develop PTSD. What then distinguishes those who develop PTSD following a trauma from those who do not?

Research on PTSD has suggested that problematic cognitive processes may result in the persistence PTSD symptoms following a trauma by maintaining a sense of threat and danger in the environment. One cognitive process that may result in the persistence of PTSD symptoms is decreased attentional control. Attentional control describes the ability to focus your attention on things you want to focus on and direct your attention away from things that distract you. Research has found that those with PTSD have more difficulty with attentional control than those without PTSD. Problems with attentional control may make it difficult to stop thinking about traumatic events. Problems directing attention away from trauma-related thoughts may lead to rumination, or repetitive thought about negative emotions or events. Like attentional control, high levels of rumination have also been found among those with PTSD. Following a trauma, those who ruminate on negative thoughts related to the event (for example, Could I have done something differently?” or “I’m damaged now”) may be more likely to develop PTSD.

The purpose of the present study was to examine the relationships between attentional control, rumination, and PTSD symptoms in a sample of trauma-exposed veterans with and without PTSD. Our findings indicate that veterans with PTSD report decreased attentional control, increased rumination, and increased PTSD symptoms compared to veterans without PTSD. These results suggest that decreased attentional control and increased rumination are not simply a result of trauma exposure, but instead may reflect pre-trauma vulnerabilities to developing PTSD. We also found that decreased attentional control was associated with increased PTSD symptoms in the total sample, and this relationship was accounted for by increased rumination. These findings suggest that decreased attentional control may lead to increased rumination, which may then contribute to increased PTSD symptoms. This study indicates that problematic cognitive processes are important targets for PTSD prevention and treatment. Future research is necessary to replicate these findings in prospective studies with diverse trauma populations.

Read the full paper: Cox, R. C., & Olatunji, B. O. (2017). Linking attentional control and PTSD symptom severity: the role of ruminationCognitive Behaviour Therapy, 1-11. doi:10.1080/16506073.2017.1286517

Rebecca Cox


Photo by: Hermann Kaser

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