Background Cognitive models of post-traumatic stress disorder (PTSD) propose that trauma entails cognitive alterations of increased distrust and perceived threat from others. We tested whether these predictions also hold in individuals with varying levels of childhood maltreatment (CM), which is much more prevalent than traumatic events as required for a PTSD diagnosis. We hypothesized that higher levels of CM would entail greater distrust and perceived threat, and that distrust would be more change-resistant in participants with more CM. Methods The study was pre-registered; the pre-registration protocol, data, and code are available at https://osf.io/pufy2/. We recruited 549 participants (M age = 29.2, 74.5% women) for an online study via websites related to CM, Borderline Personality Disorder, and via snowball method on social media. Participants self-reported their level of CM on the childhood trauma questionnaire (CTQ). Next, they played two rounds of a hypothetical distrust game, indicating the perceived trustworthiness of avatars by way of estimating expected monetary deductions from them (i.e. higher amounts indicating greater distrust). After the first round, we provided participants with the feedback that very little money was taken from them. We expected those with more CM to be less responsive to the positive feedback and to adapt their estimates less in the subsequent round. Following the distrust game, participants completed an emotion rating task in which they rated the emotional expressions of 60 faces on a scale from ‘very negative’ to ‘very positive’. We included angry, fearful, and happy facial expressions, and expected individuals with higher CM levels to provide more negative ratings. We conducted linear mixed effects models with random intercepts for raters and stimuli (crossed), and modelled random slopes for all within-person predictors. Results As hypothesized, higher levels of CM were associated with higher levels of distrust and a weaker decrease in distrust following positive feedback. Further supporting our hypotheses, individuals with higher levels of CM showed more negatively shifted emotion ratings. Conclusions Increased distrust and perceived interpersonal threat following trauma, as proposed in cognitive models of PTSD, likely also apply to individuals with CM, following a dose-response relationship. We discuss clinical implications of considering any level of CM as a potentially relevant treatment-factor, even when a trauma-related disorder is not the main diagnosis, and propose future research avenues.

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Previous laboratory studies have demonstrated that an observer's current mood can influence their processing of facial stimuli, for instance the appraisal of facial affect. The aim of the present study was to explore the association between current mood and face processing in participants' daily lives, thereby making use of naturally occurring affective states. We employed Ambulatory Assessment (AA) and included two experimental tasks to test whether current mood predicts how participants evaluate (i) the valence of emotional faces and (ii) facial trustworthiness. We hypothesized a mood congruent processing, such that individuals would rate pictures of faces more negatively and less trustworthy, the more negative their current mood was. We recruited 42 participants who completed a 7-day AA study with six random prompts per day. At each prompt, participants provided self-reports on momentary mood and completed an emotion rating task and a hypothetical distrust game. Results show that negative momentary mood was significantly associated with higher levels of distrust, but was not significantly associated with more negative emotion ratings. We discuss the incremental value and feasibility of implementing experimental tasks in AA contexts and the opportunities this opens for assessing affective and cognitive processes in natural environments.

Objectives Childhood trauma constitutes a major risk factor for adult psychopathology, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and somatic symptom disorder (SSD). One potential mechanism linking childhood trauma to adult psychopathology may be alterations in theory of mind (ToM). Given the lack of transdiagnostic studies on the association between childhood trauma and ToM, further research is needed to elucidate whether and how childhood trauma relates to ToM impairments across and within diagnostic boundaries. Design A cross‐sectional study design was applied. Methods A total of 137 individuals with varying levels of childhood trauma took part in this study, encompassing individuals with PTSD (n = 33), MDD (n = 33), SSD (n = 36), and healthy volunteers (HVs; n = 35). To assess ToM performance and childhood trauma, the Movie for the Assessment of Social Cognition was administered along with the Childhood Trauma Questionnaire. Results Only individuals with PTSD, but not individuals with MDD or SSD, showed a worse ToM performance compared to HVs. In the whole sample, childhood trauma correlated negatively with ToM performance. Exploratory group‐specific analyses revealed higher levels of childhood trauma to be associated with more excessive ToM errors in individuals with SSD, and notably with an enhanced ToM performance in individuals with MDD. Conclusions Our results indicate associations between childhood trauma and ToM impairments in a large, transdiagnostic sample. Provided replication in future studies, our findings suggest ToM capacities as a promising treatment target for individuals exposed to severe childhood trauma, at least or particularly with a diagnosis of PTSD. Practitioner points Our results suggest that individuals with a history of severe childhood trauma, at least or particularly with a clinical diagnosis of posttraumatic stress disorder, may benefit from therapeutic approaches targeting theory of mind capacities. Our findings indicate that higher levels of childhood trauma may be linked to a specific ‘hypermentalizing’ bias in somatic symptom disorder. Our findings further point towards an association between higher levels of childhood trauma and a heightened – rather than a diminished – sensitivity towards interpersonal cues in major depressive disorder. Provided further confirmatory evidence, our findings may support diagnosis‐specific approaches in ameliorating theory of mind abilities in individuals with different mental disorders and a history of severe childhood trauma.

Evidence on individuals affected by posttraumatic stress disorder (PTSD) following childhood maltreatment (CM) supports cognitive models suggesting that trauma engenders distrust and interpersonal threat sensitivity. We examined the associations between CM and both distrust and interpersonal threat sensitivity in daily life and investigated whether momentary negative affect (NA) provides a context that strengthens this association. Hypotheses were based on cognitive models of trauma and the feelings‐as‐information theory. In a 7‐day ambulatory assessment study with six semirandom daily prompts (2,295 total), we measured self‐reported momentary NA and assessed behavioral trust as well as interpersonal threat sensitivity via facial emotion ratings with two novel experimental paradigms in 61 participants with varying levels of CM (45,900 total trials). As hypothesized, NA was associated with increased momentary distrust, β = .03, p = .002, and interpersonal threat sensitivity, β = −.01, p = .021. Higher levels of CM were associated with more negative emotion ratings, independent of affective context, β = −.07, p = .003. Momentary behavioral distrust was associated with CM at high levels of momentary NA, β = .02, p = .027. The findings for both tasks support the feelings‐as‐information theory and suggest that cognitive alterations surrounding distrust and interpersonal threat, which were originally proposed for PTSD, likely also affect individuals with a history of CM.

article in press, Cognition & Emotion. ABSTRACT: Previous laboratory studies have demonstrated that an observer’s current mood can influence their processing of facial stimuli, for instance the appraisal of facial affect. The aim of the present study was to explore the association between current mood and face processing in participants’ daily lives, thereby making use of naturally occurring affective states. We employed Ambulatory Assessment (AA) and included two experimental tasks to test whether current mood predicts how participants evaluate (i) the valence of emotional faces and (ii) facial trustworthiness. We hypothesized a mood congruent processing, such that individuals would rate pictures of faces more negatively and less trustworthy, the more negative their current mood was. We recruited 42 participants who completed a 7-day AA study with six random prompts per day. At each prompt, participants provided self-reports on momentary mood and completed an emotion rating task and a hypothetical distrust game. Results show that negative momentary mood was significantly associated with higher levels of distrust, but was not significantly associated with more negative emotion ratings. We discuss the incremental value and feasibility of implementing experimental tasks in AA contexts and the opportunities this opens for assessing affective and cognitive processes in natural environments.

This manuscript is accepted for publication in the Journal of Traumatic Stress (2023/04/20). Abstract: Cognitive models suggest that trauma engenders distrust and interpersonal threat sensitivity, which is supported by previous evidence on individuals affected by posttraumatic stress disorder (PTSD) after childhood maltreatment (CM). We tested whether CM is associated with distrust and interpersonal threat sensitivity in daily life, and whether momentary negative affect (NA) provides a context that strengthens this association. Hypotheses were based on cognitive models of trauma and the feelings-as-information theory. In a seven-day ambulatory assessment study with six semi-random daily prompts (2,295 total), we measured self-reported momentary NA, and assessed behavioral trust as well as interpersonal threat sensitivity via facial emotion ratings with two novel experimental paradigms in 61 individuals with varying levels of CM (45,900 trials total). As hypothesized, NA was associated with increased momentary distrust (ß = 0.03, p = .002) and interpersonal threat sensitivity (ß = -0.01, p = .021). Higher levels of CM were associated with more negative emotion ratings, independent of affective context (ß = -0.07, p = .003). Momentary behavioral distrust was associated with CM at high levels of momentary NA (ß = 0.02, p = .027). Findings for both tasks support the feeling-as-information theory and suggest that cognitive alterations surrounding distrust and interpersonal threat, which were originally proposed for PTSD, likely also affect those with CM.