Information processing biases in posttraumatic stress disorder (PTSD): cross-sectional findings and exploratory investigation of bias changes following treatment

Background: Information processing biases are ascribed an important role in the aetiology and maintenance of posttraumatic stress disorder (PTSD). While findings on attentional biases have been mixed, there are only a few studies that have used implicit measures to assess dysfunctional appraisals and their malleability over the course of treatment in PTSD.Objective: The primary aim was to examine whether individuals with PTSD (1) show attentional biases towards trauma-related stimuli, (2) generate more implicitly assessed dysfunctional appraisals, and (3) more strongly associate the self as traumatized and vulnerable compared to traumatized individuals without PTSD and a healthy control group. The second and exploratory aim was to explore whether biases would be reduced after treatment.Method: Participants included individuals with PTSD (n = 50), traumatized individuals without PTSD (n = 54), and healthy controls (n = 57). Attentional biases were measured with a Visual Search Task, dysfunctional appraisals with a scenario task, and trauma-related self-appraisals with two Implicit Association Tests (self-traumatized, self-vulnerability). In exploratory analyses, changes in these measures were examined across treatment.Results: No significant differences were found in attention allocation to trauma-related stimuli between groups. However, participants with PTSD generated more dysfunctional appraisals and demonstrated stronger trauma-related associations than both control groups. Importantly, treatment significantly reduced dysfunctional appraisals and fostered more functional self-appraisals in the IAT.Conclusions: Implicitly assessed dysfunctional (self-) appraisals differentiate individuals with PTSD from controls and appear responsive to treatment. Future research should clarify whether these implicit biases function as mechanisms of change and predict long-term clinical outcomes.