Introduction: Dysfunctional appraisals about traumatic events and their sequelae are a key mechanism in posttraumatic stress disorder (PTSD). Experimental studies have shown that a computerized cognitive training, cognitive bias modification for appraisals (CBM-APP), can modify dysfunctional appraisals and reduce analogue trauma symptoms amongst healthy and subclinical volunteers. Objective: We aimed to test whether CBM-APP could reduce dysfunctional appraisals related to trauma reactions in PTSD patients, and whether this would lead to improvements in PTSD symptoms. Methods: We compared CBM-APP to sham training in a parallel-arm proof-of-principle double-blind randomized controlled trial amongst 80 PTSD patients admitted to an inpatient clinic. Both arms comprised a training schedule of 8 sessions over a 2-week period and were completed as an adjunct to the standard treatment programme. Results: In intention-to-treat analyses, participants receiving CBM-APP showed a greater reduction in dysfunctional appraisals on a scenario task from pre- to posttraining (primary outcome) assessments, compared to those receiving sham training (d = 1.30, 95% CI 0.82–1.80), with between-group differences also found on the Posttraumatic Cognitions Inventory (PTCI; d = 0.85, 95% CI 0.39–1.32) and the PTSD Checklist for DSM-5 (PCL-5; d = 0.68, 95% CI 0.23–1.14), but not for long-term cortisol concentrations (d = 0.25, 95% CI –0.28 to 0.78). Reductions in dysfunctional appraisals assessed via the scenario task correlated with reductions on the PTCI, PCL-5, and hair cortisol concentrations from pre- to posttraining time points. Conclusions: Results support dysfunctional appraisals as a modifiable cognitive mechanism, and that their proximal modification transfers to downstream PTSD symptoms. These findings could open new avenues for improving present therapeutic approaches.

No abstract

No abstract

The Scrambled Sentences Task (SST) is frequently used to assess interpretation biases (IBs). However, neither the range of its applications nor the quality of the empirical evidence it provides has been systematically examined. This systematic review investigates the types of samples and disorders in which the SST has been applied and evaluates its psychometric properties. The databases PubMed and EBSCOhost (including PsycINFO, PsycARTICLES, PSYNDEX, MEDLINE) were examined (last search: March 2021) and 89 studies from 86 manuscripts were included. Results showed that the SST has been applied predominantly in unselected samples or those with elevated levels of subsyndromal symptoms, with about a third of the studies applying the SST in a clinical population. While the SST was initially developed to assess depression-related IBs, its use has now been extended to many other disorders, in particular anxiety disorders. The convergent validity of the SST was found to be good, yet results concerning divergent validity were more mixed with high correlations across disorders between the SST and trait-anxiety in particular, questioning its specificity. Reliability was generally sufficient, yet seldom reported. Questions for future research concern the SST’s test-retest reliability and its relationship with other direct or indirect measures of IBs.

Major life events can lead to depression in adulthood. However, as predicted by several depression theories (e.g., Hopelessness Theory of Depression), not only the mere occurrence of major life events but also the way people perceive them determines the onset of a depression. In this systematic review, we narratively summarized 276 studies (total N = 89,600) investigating the relationship between the perception of major life events and depression. Cross-sectionally, several perceived event characteristics such as globality, valence, impact, distress, and loss were consistently associated with depression. Furthermore, some perceived event characteristics such as a negative attributional style and event centrality predicted the onset of depression or changes in depressive symptoms over time. However, longitudinal studies on the relationship between perceived event characteristics and depression were scarce. In general, our review supports the relevance of the perceived event characteristics proposed in Hopelessness Theory of Depression (e.g., stability, internality, globality, and their composite scores) and other depression theories. However, further longitudinal research considering a range of different perceived event characteristics, using non-Western heterogeneous samples, and different retest intervals are needed to better understand the association between the perception of major life events and depression.