Linking neural mechanisms of emotion and attention with naturalistic trauma symptom experience: An event-related potential and ecological momentary assessment study

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Project Summary: Around 70% of individuals will experience a significant traumatic event in their lifetime. Although the presence of any trauma is associated with disruptions to cognitive and emotional reactions to everyday events, experiencing an interpersonal trauma (e.g., assault, abuse) is associated with increased symptoms of post-traumatic stress (PTS) relative to impersonal traumas (e.g., disasters, accidents), and appears to follow a separate, more severe symptomatic etiology. Collectively, symptoms following a traumatic event (i.e., intrusive thoughts, avoidance symptoms, negative alterations to cognitions and mood, hypervigilance and reactivity) cause substantial burden on both individual functioning and behavioral health services. While the presence of all four of these symptom clusters comprise a diagnosis of Post-Traumatic Stress Disorder (PTSD), affecting 8.3% of individuals in their lifetimes, an additional 14.7% will experience sub- threshold symptoms of PTS, associated with similar functional difficulties to PTSD (i.e., depressive symptoms, psychiatric comorbidity, social/occupational difficulties, impulsive coping and substance use, increased aggression/hostility, and suicidal ideation). However, most research on PTS utilizes a categorical approach to symptom differentiation, combines trauma types that may have separate etiological pathways, relies on cross- sectional research designs, and fails to incorporate multiple units of analysis. The present study utilizes a transdiagnostic approach to assess neurocognitive vulnerability and the daily experience of PTS symptoms by incorporating electroencephalography/event-related potentials (EEG/ERP) to assess neural mechanisms of emotion regulation and attention to idiographic, trauma-relevant stimuli. Baseline self-report measures of symptoms will be supplemented with ecological momentary assessments (EMA) for a two-week follow-up period to assess daily symptoms of PTS and reactions to acute stressful events in naturalistic settings. Project aims include (1) To assess if emotion regulation and attention bias to idiographic stimuli relevant to an index trauma can establish neural markers for PTS and (2) To investigate if EMAs can be used to detect differences in frequency and severity of symptoms of traumatic intrusions, hypervigilance and reactivity, negative cognitions and mood, and avoidance symptoms following daily negative experiences. Multilevel models will be used to integrate these data to assess the relationship between baseline neural markers and daily trauma symptoms. The objectives and directions of this research are consistent with the NIMH Strategic Plan, specifically by assessing mental illness by probing the course of PTS symptomatology in the aftermath of psychologically disruptive events (i.e., trauma) through the analysis of biological, behavioral, and environmental contributors to symptom heterogeneity with techniques integrating repeated ecological assessments. This project aims to integrate understanding of biological and behavioral indicators of dimensional constructs of PTS that carry implications for novel treatment targets and the prediction of symptom course and severity.