(PS11-A16) Impact of Trauma Exposure and Posttraumatic Stress Symptoms on Baseline Self-reported Safety Behaviors versus Observer-rated Safety Behaviors During the Trauma Film Paradigm

Impact of trauma exposure and posttraumatic stress symptoms on baseline self-reported safety behaviors versus observer-rated safety behaviors during the trauma film paradigm

Caleb Woolston¹, Manny Gutierrez Chavez, B.S.¹, Kiran Kaur, M.S^.1,

Jason Goodson, Ph.D.², & Anu Asnaani, Ph.D.¹

¹University of Utah

²Salt Lake City VA

Abstract

Background: Posttraumatic stress disorder (PTSD) is a high-burden disorder characterized by an ongoing sense of threat. Safety Behaviors (SBs), which are covert or overt actions used to escape distressing emotions, play a central role in the onset and maintenance of PTSD, with suppression of trauma-related memories and vigilance strategies being common examples.  However, literature suggests scores on observer-rated and self-reported SBs can be discrepant, creating a need to examine if this discrepancy exists in those who have had a traumatic exposure or in those with both trauma exposure and significant PTSD symptoms, to examine how SBs may present as a result of PTSD and/or trauma. We expected that the presence of significant PTSD symptoms would be correlated with greater SBs and would result in a greater discrepancy between these two types of SB-reporting.

Methods: We used an analysis of variance (ANOVA) to examine difference scores between an observer-rated measure of SBs (i.e., video coding by trained raters) versus a self-reported measure of SBs in participants exposed to trauma-related films. This was done across three groups: adults (aged 18-41 years; 38% racial/ethnic minorities and 73% female) with no trauma exposure (n= 77), those with trauma exposure but minimal symptoms (n= 49) and those with trauma exposure and likely PTSD (n=24).

Results: PTSD symptoms were correlated with self-reported SBs (r = .44, p< .001), but not observer-rated SBs (r = -.15, p=.30). The ANOVA revealed a significant difference between self-reported and observer-rated SBs for those with probable PTSD compared to the other groups, who did not show this discrepancy between types of SBs (F(2,101) =3.53, p= .03), such that those with likely PTSD had greater self-reported SBs than observer-rated SBs.

Conclusions: Our finding that having probable PTSD resulted in significant discrepancy in types of SBs suggests SBs may be more covert for individuals with PTSD and harder for observers to spot in clinical and/ or research settings. Such findings can potentially assist clinicians in their assessment of SBs and provide researchers with more accurate methods of detecting such behaviors in order to better understand how SBs maintain symptoms of PTSD and how such behaviors may be better targeted to promote wellness and recovery in those with PTSD.