Affective lability predicts decreased habituation in posttraumatic stress symptom responding during a single laboratory session of imaginal exposure

Abstract

Affective lability, or the instability of emotional states, is associated with heightened levels of trauma-related emotional responding and posttraumatic stress disorder (PTSD) symptoms. However, the impact of affective lability, specifically on habituation to idiographic trauma cues, has yet to be examined among trauma-exposed individuals. The current study examined differential response trajectories to trauma-related imaginal exposure as a function of affective lability. Specifically, 72 women with a history of sexual victimization participated in a laboratory-based study involving a single session of repeated imaginal exposures to idiographic traumatic event cues. As hypothesized, participants higher in affective lability reported less reduction in trauma-cue elicited posttraumatic stress symptoms across exposure trials. Given these results, it will be important to continue to extend these laboratory findings to better understand how elevated affective lability is related to response to trauma-focused exposure therapy among individuals with PTSD or other trauma-related psychopathology (e.g., borderline personality disorder).

Trauma informed interventions: A systematic review

“…Table 1 summarizes the main characteristics of the 32 unique studies included in the review, with one companion article [16] for a study which was later reported with a more thorough examination of findings [17] totaling 33 articles. More than half (n = 19) of the 32 studies were RCTs [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] whereas twelve studies were quasi-experimental [36][37][38][39][40][41][42][43][44][45][46][47] and one was retrospective study [48]. Thirteen studies were conducted in the U.S. [17][18][19]22,26,27,29,35,[39][40][41]45,47]; five in the Netherlands …”

“…The average sample size was 78 participants, with a range from 10 participants [38] to 297 participants [48]. Of the studies included, 67% had a sample size above 50 [18][19][20][21][22]26,[29][30][31][32][33][34]36,37,[39][40][41][42][46][47][48].…”

“…The studies included in this review recruited their study populations largely based on the type of trauma they were aiming to address, such as individuals that experienced interpersonal traumatic event such as child abuse, sexual assault, or domestic violence [16][17][18][20][21][22][24][25][26]35,[40][41][42][43]45,46], individuals with substance abuse disorders [19,47,48], couples experiencing clinically significant marital issues [23], individuals with limb amputations [38], dental phobia [28], or fire service personnel suffering from post-traumatic stress disorder [44]. Trauma was self-reported in eight articles [16,17,20,22,26,34,35,47].…”

“…Two studies used a clinical tool (e.g. eye movement desensitization and reprocessing [38] and Diagnostic and Statistical Manual of Mental Disorders, 4 th edition [41] to identify or diagnose trauma. Fifteen studies did not include direct measurements for trauma [21,24,[28][29][30][31][32][33]36,37,40,[42][43][44]48].…”

Emotional lability and affective synchrony in posttraumatic stress disorder pathology

“…Although limited, research provides evidence of a positive association between PTSD symptoms and trait emotional lability (Lindley, Carlson, & Benoit, 2004; Marshall-Berenz, Morrison, Schumacher, & Coffey, 2011), and suggests that trait emotional lability may interfere with habituation to trauma-related cues in PTSD. Specifically, Dutton, Badour, Jones, Mischel, and Feldner (2016) found that repeated exposure to trauma cues facilitated reductions in state PTSD symptoms only in the context of low trait emotional lability. Additionally, experience sampling studies have revealed positive associations between PTSD pathology and negative emotion lability, with Newton and Ho (2008) finding that state lability of anxiety and anger over a one day period was associated with greater PTSD symptom severity among women exposed to interpersonal traumas.…”