The influence of mild traumatic brain injury on attentional Bias: Preliminary evidence

Traumatic brain injury (TBI) is a common neurological condition associated with attentional disruption and emotional vulnerability. Although attentional bias toward emotionally salient stimuli is implicated in depression, anxiety, and posttraumatic stress disorder (PTSD), its role in individuals with a history of TBI remains poorly understood. This study examined whether TBI moderates the associations between attentional bias and (1) depressive, anxiety, and stress symptoms, and (2) exposure to traumatic events meeting Criterion A for PTSD, defined as exposure to actual or threatened death, serious injury, or sexual violence.

Participants were drawn from two independent adult community samples recruited via established online research platforms (Amazon Mechanical Turk and Prolific; N = 92). Attentional bias was assessed using response-based computation, which yields separate indices of attentional vigilance and avoidance. History of TBI was assessed using a single self-report head injury screening item assessing loss of consciousness or altered mental state following head injury. Multilevel Bayesian regression models were used to test main effects and moderation hypotheses.

There were no main effects of TBI history on attentional bias. However, TBI moderated associations between attentional vigilance and emotional symptoms. Specifically, higher levels of depressive, anxiety, and stress symptoms were associated with greater attentional vigilance only among individuals with a history of TBI. In contrast, among individuals exposed to Criterion A traumatic events, attentional vigilance was elevated in those without TBI history but attenuated in those with TBI history. No moderation effects were observed for attentional avoidance.

Findings provide evidence that a history of TBI shapes attentional vigilance in a context-dependent manner. TBI history may amplify vigilance in the presence of elevated emotional distress while dampening vigilance in response to trauma-related cues. These results underscore the importance of accounting for TBI history when examining cognitive-affective processes and may help explain variability in attentional bias findings across non-clinical populations.