Posttraumatic Stress and the Comprehension of Everyday Activity

Abstract

Posttraumatic Stress Disorder (PTSD) is a disabling disorder with a lifetime prevalence of 6.8% in the United States [1]. Symptoms of PTSD include reexperiencing (e.g., flashbacks), avoidance and numbing (e.g., avoidance of thoughts or places related to the trauma), and increased arousal (e.g., hypervigilance; [2]). People with PTSD also often report impairments in attention and memory on tasks that are not directly related to their traumatic event, such as difficulty remembering a phone number or following a conversation. These symptoms can severely interfere with daily functioning, often limiting a person's ability to work, raise a family, and participate in other activities of daily life [3]. However, we know of no research on how people with symptoms of PTSD comprehend and remember everyday events. The present study therefore asked whether PTSD symptom severity is negatively associated with comprehension and memory of ongoing, naturalistic activity.Hypervigilance, one of the symptoms of increased arousal, may have a particular influence on the way people perceive ongoing activity during everyday life. Hypervigilance results in a state of alertness focused on identifying potentially threatening stimuli [3]. Though hypervigilance can be extremely disruptive for people with PTSD, it is maintained because people with PTSD believe constant alertness will prevent them from experiencing future traumatic events [4]. This may be a normal and adaptive response immediately after a traumatic experience, when threats may still linger [5]; however, when constant alertness continues long after the trauma, as it does in PTSD, it likely adversely impacts people's perception of non-threatening information. For example, the loud noise of a door closing might trigger a combat veteran to take cover because the door's sound is similar to the sound of a bomb exploding. This type of reaction could severely impact the way people perceive, comprehend, and remember ongoing activity, even activity unrelated to their traumatic event.Though people with PTSD may be hyper-attentive to components of the environment that are reminiscent of their traumatic event, this likely comes at a cost to their ability to pay attention to other features of the environment. In fact, there has been some research suggesting that symptoms of PTSD affect the processing of non-trauma related information, though these studies have not included ongoing, naturalistic stimuli. Many of these studies examined event-related potentials (ERPs), including the P300 response (associated with an enhancement of attention to stimuli; see [6] for a review of the P300), to determine how PTSD symptoms affect responses to unexpected auditory tones, words, and pictures. For example, in a meta-analysis of ERP studies in people with PTSD, Karl, Malta, and Maercker [7] found evidence suggesting that people with PTSD displayed reduced arousal in response to neutral information (reduced P300 response) but increased arousal in response to both is the segmentation of ongoing activity i...

Event boundaries in memory and cognition

“…For example, older adults’ event boundaries show less agreement with each other than do younger adults’, and older adults with early-stage Alzheimer’s disease show even lower agreement [42, 43, 44, 45]. Deviations from normative segmentation also have been reported for people with traumatic brain injury [46], lesions to prefrontal cortex [47], post-traumatic stress symptoms [48], schizophrenia [49], and intellectual disability [50]. When interpreting these group differences, it is important that in some cases group differences in observed segmentation could arise from differences in cognitive capacities that are not strictly related to segmentation, such as the ability to interpret and retain task instructions, or to remain on task.…”

Constructing Experience: Event Models from Perception to Action

“…Deficits in event cognition have been identified in individuals with characteristics of autism [119], schizophrenia [128], Alzheimer’s disease [50], post-traumatic stress disorder [129], and obsessive-compulsive disorder [130]. Researchers studying several of these disorders have suggested that event-comprehension interventions have promise in remediating the disorders’ symptoms or compensating for their effects [124, 131, 132].…”

Psychopathology applications of event perception basic research: Anticipating the road ahead using posttraumatic stress disorder as an example.

“…Preliminary evidence supports the use of event perception theories and methods to improve our understanding of how PTSD initially develops (Sherrill et al, 2016) and how PTSD may be related to everyday cognitive functioning (Eisenberg et al, 2016). The extant literature warrants a range of additional studies to estimate effect sizes between constructs and to isolate mediating mechanisms.…”

“…The association between PTSD symptom severity and diminished segmentation provides impetus to explore a wide range of empirical questions. First, additional variables should be explored that could explain the current correlational data (Eisenberg et al, 2016). One possibility is that a vulnerability to develop PTSD is premorbid low segmentation-ability or factors contributing to low segmentation-ability such as trait dACC hyperactivation (Shin et al, 2009) or deficits in cognitive functioning (Brewin, 2011; Buckley, Blanchard, & Neill, 2000).…”

“…Researchers have argued that event segmentation is relevant to functional outcomes for a range of clinical conditions including schizophrenia (Richmond et al, 2017), obsessive-compulsive disorder (OCD; Zacks & Sargent, 2010), traumatic brain injury (Zacks, Kurby, Landazabal, Krueger, & Grafman, 2016), and posttraumatic stress disorder (PTSD; Eisenberg, Sargent, & Zacks, 2016). Within the domain of psychopathology, PTSD is of particular interest (Eisenberg et al, 2016; Sherrill, Lilly, & Magliano, 2016). Richmond et al (2017) address wide-ranging translational issues regarding applications of event segmentation to clinical contexts and thus do not provide a level of detail required for specific clinical applications.…”