Teaching with the Journal of Traumatic Stress (JOTS) II

Kathryn Becker-Blease, PhD

In the first Teaching Trauma with JOTS column, I introduced the idea of using articles from the Journal of Traumatic Stress (JOTS) to teach both trauma and scientific literacy using MCAT-style multiple choice tests. Multiple-choice tests, when carefully constructed, are an easy way for instructors to not just assess knowledge, but also teach, even in large lecture courses.

In this column, I present a second MCAT-style question along with some resources for teaching about a recent Journal of Traumatic Stress publication. This question may be rather technical for some classes, but is a great way of showing students in appropriate classes the breadth of research methods that researchers use to study trauma.

Resources

Dot Probe Task: Static diagrams explaining the sequence of dot probe screen shots are available in a basic web search for “dot probe task”. To be consistent with the methodology in this study, choose one with threat-related words (not images).

A web-based demonstration of a dot-probe task is available at http://www.millisecond.com/download/library/v4/DotProbe/DotProbe.web. It requires a software download that was quick and easy on my desktop, but would need to be set up before presenting in a classroom.

Note: The MCAT-style question below is based on the following article:
Iacoviello, B. M., Wu, G., Abend, R., Murrough, J. W., Feder, A., Fruchter, E., Levinstein, Y., Wald, I., Bailey, C., Pine, D., Neumeister, A., Bar-Haim, Y. & Charney, D. S. (2014). Attention bias variability and symptoms of posttraumatic stress disorder. Journal of Traumatic Stress, 27(2), 232-239. doi: 10.1002/jts.21899

Attentional Control and PTSD

In the dot-probe task, participants are shown neutral (e.g. dishwasher) and threat-related (e.g. death) words that appear at the top or bottom of a computer screen. They are told to focus at the center of the screen while the words appear. In between the words, a symbol appears at the top or bottom of the screen. Researchers measure how quickly participants identify the symbol. If participants do not have any attentional bias, they are equally fast whether the symbol appears in the same location as a neutral or a threat-related world just appeared. If they have a bias toward threat-related words, they will respond faster when the symbol appears in the same location as a threat-related word just appeared. If they have an attentional bias to avoid threat-related words, they will be faster when the symbol appears in the same location as a neutral word just appeared.

The results of several studies have been inconclusive; some studies show that people with PTSD have an attentional bias toward threat-related words and others show an attentional bias away from threat-related words. In the results presented below, the researchers asked a different question. Instead of focusing on speed or attentional bias overall, they looked how variable, or inconsistent, participants’ scores were during the task. They reasoned that a lack of attention control, operationally defined as variability in scores, may be associated with more PTSD symptoms.

The results, shown in Figure 1 (click to enlarge) and Table 1, were consistent with their prediction. Attentional control may be an important factor in the development of PTSD, and it may also account for the inconsistent findings in previous studies.

Table 1. Reaction Time Variability is Positively Related to Mental Health Symptoms

The main finding in this study is that post-traumatic stress symptoms are associated with:

1.     faster processing of threatening information.

2.     anxiety and depression symptoms.

3.     less consistency in the speed of processing threatening information.

4.     a bias toward paying attention to threatening information.

What evidence presented here supports the conclusion that attentional control is associated specifically with PTSD and not just having experienced a traumatic event?

1. Variability scores for the traumatized group are statistically significantly higher than for the non-traumatized, non-PTSD group.

2.  Variability scores for the traumatized group are statistically significantly lower than for the non-traumatized, non-PTSD group.

3.  Variability scores for the PTSD group are statistically significantly lower than for the traumatized without PTSD group.

4.  Variability scores for the PTSD group are statistically significantly higher than for the traumatized without PTSD group.

1.     the more variable their reaction times.

2.     the less variable their reaction times.

3.     the faster their reaction times.

4.     the slower their reaction times

1.     .09
2.     .11
3.     .37
4.     .43

1. conducting an experiment (Note: or randomized control trial, depending on the terminology in your course).
2.  manipulating the dependent variable.
3.  conducting a case study.
4.  unable to rule out the possibility that people with poorer attentional control get more PTSD because they are more likely to get into car accidents.

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