Distress Intolerance Prospectively Predicts Traumatic Intrusions Following an Experimental Trauma in a Non-clinical Sample

Posttraumatic stress, visual working memory, and visual imagery in military personnel

Posttraumatic stress disorder (PTSD) is characterized by disruptions to cognitive functioning. Two studies were conducted to examine the relevance of military-related PTSD to two cognitive functions - visual working memory and visual imagery. Participants were military personnel who reported their PTSD diagnosis history and completed a self-administered screening tool for PTSD, the PTSD Checklist - Military Version. In Study 1, 138 personnel also completed a memory span task and a 2-back task using colored words in which Stroop interference was introduced via the semantic content of the words. In Study 2, a separate group of 211 personnel completed measures of perceived imagery vividness and spontaneous use of visual imagery. Interference effects on working memory in PTSD-diagnosed military personnel were not replicated. However, ANCOVA and structural equation modelling revealed that PTSD-intrusions were associated with poorer working memory whereas PTSD-arousal was associated with spontaneous use of visual imagery. We interpret these results as evidence that intrusive flashbacks disrupt working memory performance not by limiting memory capacity nor by interfering directly with memory functions such as inhibition, but by adding internal noise in the form of task-irrelevant memories and emotions. Visual imagery appears to be unrelated to these flashbacks but with arousal symptoms of PTSD, perhaps in the form of flashforwards about feared/anticipated threats.

Synthesis of evidence on the use of ecological momentary assessments to monitor health outcomes after traumatic injury: rapid systematic review

BACKGROUND

With the increasing use of mobile technology, ecological momentary assessments (EMAs) may enable routine monitoring of patient health outcomes and patient experiences of care by health agencies. This rapid review aims to synthesise the evidence on the use of EMAs to monitor health outcomes after traumatic unintentional injury.

METHOD

A rapid systematic review of nine databases (MEDLINE, Web of Science, Embase, CINAHL, Academic Search Premier, PsychINFO, Psychology and Behavioural Sciences Collection, Scopus, SportDiscus) for English-language articles from January 2010-September 2021 was conducted. Abstracts and full-text were screened by two reviewers and each article critically appraised. Key information was extracted by population characteristics, age and sample size, follow-up time period(s), type of EMA tools, physical health or pain outcome(s), psychological health outcome(s), general health or social outcome(s), and facilitators or barriers of EMA methods. Narrative synthesis was undertaken to identify key EMA facilitator and barrier themes.

RESULTS

There were 29 articles using data from 25 unique studies. Almost all (84.0%) were prospective cohort studies and 11 (44.0%) were EMA feasibility trials with an injured cohort. Traumatic and acquired brain injuries and concussion (64.0%) were the most common injuries examined. The most common EMA type was interval (40.0%). There were 10 key facilitator themes (e.g. feasibility, ecological validity, compliance) and 10 key barrier themes (e.g. complex technology, response consistency, ability to capture a participant's full experience, compliance decline) identified in studies using EMA to examine health outcomes post-injury.

CONCLUSIONS

This review highlighted the usefulness of EMA to capture ecologically valid participant responses of their experiences post-injury. EMAs have the potential to assist in routine follow-up of the health outcomes of patients post-injury and their use should be further explored.