Adaptation under fire: The effect of updating flexibility during cumulative trauma

Direct and indirect traumatic exposure during ongoing continuous trauma often leads to increased anxiety symptoms, which may cause distress and disrupt daily functioning. Previous research has shown that updating flexibility can attenuate the positive association between levels of exposure and the tendency to develop clinical symptoms. Here, we suggest that in line with the predictive-processing framework, this can be done by updating prior beliefs based on new relevant, but not irrelevant, information. Such ability is especially important during an ongoing war, where extensive exposure to traumatic events may destabilize prior beliefs and lead to information overload. The current study tested for the first time the moderating role of belief updating in the relationship between trauma exposure and anxiety during the first month of an ongoing war while differentiating between the possible effects of direct and indirect exposure. Participants were assessed for trauma exposure and clinical symptoms and completed a well-validated performance-based paradigm to evaluate belief updating. The results revealed that belief updating moderated the relationship between indirect, but not direct, trauma exposure and anxiety. Specifically, for individuals with impaired belief updating, there was a positive association between levels of indirect traumatic exposure and anxiety symptom severity. In contrast, those with flexible belief updating maintained lower levels of symptoms independent of their exposure. Interestingly, direct exposure increased anxiety symptoms regardless of flexibility in belief updating. The results highlight the need for developing tailored interventions that consider belief updating and exposure type to reduce clinical symptoms and improve well-being during ongoing crises.