Patterns of attentional and cognitive biases in community trauma survivors: an eye tracking study

Introduction: This study investigated the associations between posttraumatic stress disorder (PTSD), depression and patterns of attentional and cognitive biases in trauma survivors.Method: Participants were assessed for trauma and completed two self-report measures to assess depression and PTSD severity. Participants completed an eye-tracking task where 45 sentence stems and 45 plausible word pair endings (one positive and one dysphoric) were presented. Sentences were related to either one's beliefs about the world or the self. Eyelink 2000® measured the amount of time participants looked at the dysphoric ending (indexing attention) and verbal endorsements of ending type were recorded (indexing cognitive interpretations).Results: Severity of PTSD and depression were highly correlated with dwell time to negative stimuli and negative verbal endorsements in world- and self-related trials. However, when entered into simultaneous regression models, differences emerged between attentional and interpretative biases. PTSD symptoms were significantly associated with dwell time to negative endings across self- and world-related stimuli. In comparison, verbal endorsements were content- and symptom-specific, with depression more strongly associated with negative interpretations of the self and PTSD more strongly associated with negative views of the world.Conclusions: This study confirmed distinct patterns of attentional and cognitive biases in trauma survivors. While PTSD symptoms were associated with attentional patterns across stimuli content (indicating a general, negative attentional bias), cognitive biases were differentiated by symptom profile (depression vs. PTSD) and stimuli content (world vs. self). Specifically, trauma survivors with more severe depression symptoms showed more negative views of the self while those with more severe PTSD symptoms showed negative views of the world. Taken together, these findings suggest that the attentional and cognitive biases after trauma differ based on the prominence of posttraumatic versus depressive symptoms and indicate the importance of distinguishing between attentional and interpretive processes in trauma-exposed populations.