Battlefield-like stress following simulated combat and suppression of attention bias to threat

Psychol Med. 2011 Apr;41(4):699-707. doi: 10.1017/S0033291710002308. Epub 2010 Nov 26.

Abstract

Background: Acute stress disorder involves prominent symptoms of threat avoidance. Preliminary cross-sectional data suggest that such threat-avoidance symptoms may also manifest cognitively, as attentional threat avoidance. Confirming these findings in a longitudinal study might provide insights on risk prediction and anxiety prevention in traumatic exposures.

Method: Attention-threat bias and post-traumatic symptoms were assessed in soldiers at two points in time: early in basic training and 23 weeks later, during advanced combat training. Based on random assignment, the timing of the repeat assessment occurred in one of two schedules: for a combat simulation group, the repeat assessment occurred immediately following a battlefield simulation exercise, and for a control group, the assessment occurred shortly before this exercise.

Results: Both groups showed no threat-related attention bias at initial assessments. Following acute stress, the combat simulation group exhibited a shift in attention away from threat whereas the control group showed no change in attention bias. Stronger threat avoidance in the combat simulation group correlated with severity of post-traumatic symptoms. Such an association was not found in the control group.

Conclusions: Acute stress may lead some individuals to shift their attention away from threats, perhaps to minimize stress exposure. This acute attention response may come at a psychological cost, given that it correlates with post-traumatic stress disorder (PTSD) symptoms. Further research is needed to determine how these associations relate to full-blown PTSD in soldier and civilian populations.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / prevention & control
  • Anxiety Disorders / psychology
  • Arousal*
  • Attention*
  • Color Perception
  • Combat Disorders / diagnosis*
  • Combat Disorders / prevention & control*
  • Combat Disorders / psychology
  • Cues*
  • Defense Mechanisms
  • Follow-Up Studies
  • Humans
  • Male
  • Military Personnel / psychology*
  • Orientation
  • Paired-Associate Learning
  • Pattern Recognition, Visual
  • Reaction Time
  • Semantics
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / prevention & control*
  • Stress Disorders, Post-Traumatic / psychology
  • Young Adult