Objective: Both theoretical and empirical studies suggest that negative cognitive biases significantly influence the onset and persistence of posttraumatic stress disorder (PTSD) symptoms. However, the interplay among these cognitive biases and their conjoint contribution to the long-term trajectory of posttraumatic stress symptoms remains underexplored. This study delves into the interplay among attention, appraisal, and memory biases within a provisional PTSD population and evaluates the predictive effects of two integrative models (weakest link, additive approach) on posttraumatic stress symptoms reported 2 months later. Method: Sixty Chinese participants (M age = 20.17, SD age = 2.11) with provisional PTSD undertook the scrambled sentences test (appraisal bias) with their eye movements recorded (attention bias) and then the free recall task (memory bias). Posttraumatic stress symptom was assessed at baseline and 2-month follow-up. Results: Selective attention bias toward negative words was positively associated with the negative appraisal of scrambled sentences, which subsequently showed a strong association with negative memory bias. Regarding the progression of posttraumatic stress symptoms, the additive approach was found to be a more reliable predictor of self-reported posttraumatic stress symptoms at 2 months than the weak link approach. Conclusions: This study provides initial evidence supporting the combined cognitive biases hypothesis in provisional PTSD. It also underscores potential avenues to enhance cognitive bias modification techniques. Replication of these findings in broader clinical samples is essential.
Clinical Impact StatementOur findings reveal a potential interplay among attention, appraisal, and memory biases in individuals with provisional posttraumatic stress disorder (PTSD). The presence and severity of posttraumatic stress symptoms seem to be associated with the overall number and magnitude of these negative cognitive processes. This insight suggests that cognitive bias modification (CBM) might be beneficial for those experiencing symptoms of provisional PTSD. Furthermore, CBM interventions that address multiple cognitive biases concurrently could potentially foster the adoption of more adaptive, positive cognitive patterns.