title: Perturbed threat monitoring following a traumatic event predicts risk for post-traumatic stress disorder.
abstract: BACKGROUND
  Post-traumatic stress disorder (PTSD) is a chronic and difficult to treat psychiatric disorder. Objective, performance-based diagnostic markers that uniquely index risk for PTSD above and beyond subjective self-report markers could inform attempts to improve prevention and early intervention. We evaluated the predictive value of threat-related attention bias measured immediately after a potentially traumatic event, as a risk marker for PTSD at a 3-month follow-up. We measured the predictive contribution of attentional threat bias above and beyond that of the more established marker of risk for PTSD, self-reported psychological dissociation.
  
  
  METHODS
  Dissociation symptoms and threat-related attention bias were measured in 577 motor vehicle accident (MVA) survivors (mean age = 35.02 years, 356 males) within 24 h of admission to an emergency department (ED) of a large urban hospital. PTSD symptoms were assessed at a 3-month follow-up using the Clinician-Administered PTSD Scale (CAPS).
  
  
  RESULTS
  Self-reported dissociation symptoms significantly accounted for 16% of the variance in PTSD at follow-up, and attention bias toward threat significantly accounted for an additional 4% of the variance in PTSD.
  
  
  CONCLUSIONS
  Threat-related attention bias can be reliably measured in the context of a hospital ED and significantly predicts risk for later PTSD. Possible mechanisms underlying the association between threat bias following a potentially traumatic event and risk for PTSD are discussed. The potential application of an attention bias modification treatment (ABMT) tailored to reduce risk for PTSD is suggested.
authors.affiliation: School of Psychological Sciences,Tel Aviv University,Israel.
authors.forename: R
authors.initials: R
authors.lastname: Naim
authors.affiliation: School of Psychological Sciences,Tel Aviv University,Israel.
authors.forename: I
authors.initials: I
authors.lastname: Wald
authors.affiliation: Emergency Medicine Department,Tel Aviv Medical Center,Israel.
authors.forename: A
authors.initials: A
authors.lastname: Lior
authors.affiliation: National Institute of Mental Health,Bethesda, MD,USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Pine
authors.affiliation: Department of Human Development,University of Maryland,College Park, MD,USA.
authors.forename: N A
authors.initials: NA
authors.lastname: Fox
authors.affiliation: School of Psychological Sciences,Tel Aviv University,Israel.
authors.forename: G
authors.initials: G
authors.lastname: Sheppes
authors.affiliation: Emergency Medicine Department,Tel Aviv Medical Center,Israel.
authors.forename: P
authors.initials: P
authors.lastname: Halpern
authors.affiliation: School of Psychological Sciences,Tel Aviv University,Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Bar-Haim
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology*; D000328:Adult; D001007:Anxiety / Q000175:diagnosis*; D001288:Attention / Q000502:physiology*; D004213:Dissociative Disorders / Q000175:diagnosis*; D005239:Fear / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D017741:Survivors / Q000523:psychology*