Abstract
To date, few studies have examined stress responses during or shortly after potentially traumatic events in real-time. In this study, a prospective Virtual Reality analogue trauma paradigm was used to assess peri- and post-traumatic stress responses in healthy individuals (N = 80). Here we compared a range of peri-traumatic psychophysiological responses following analogue trauma to a control condition. Furthermore, we aimed to identify essential regulatory mechanisms in response to an analogue trauma and their effects on subsequent analogue trauma symptoms. Therefore, we examined the impact of subjective and physiological emotional responses, cognitive processing, cognitive regulation and appraisal as well as flexible emotion regulation on analogue trauma symptoms. Results of the hierarchical multiple regression analyses revealed that cognitive processing as well as cognitive regulation and appraisal predicted analogue trauma symptoms beyond psychophysiological responses, while flexible emotion regulation was uniquely predictive only directly afterwards. The findings provide evidence that flexible emotion regulation might be in particular protective directly after trauma exposure and highlight the general importance of peri- and post-traumatic cognitive factors in the development and maintenance of stress-associated psychopathology, thereby supporting cognitive models of PTSD.
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Aakvaag, H. F., Thoresen, S., Wentzel-Larsen, T., Dyb, G., Røysamb, E., & Olff, M. (2016). Broken and guilty since it happened: A population study of trauma-related shame and guilt after violence and sexual abuse. Journal of Affective Disorders, 204, 16–23. https://doi.org/10.1016/J.JAD.2016.06.004.
Aakvaag, H. F., Thoresen, S., Wentzel-Larsen, T., Røysamb, E., & Dyb, G. (2014). Shame and guilt in the aftermath of terror: The Utøya Island Study. Journal of Traumatic Stress, 27(5), 618–621. https://doi.org/10.1002/jts.21957.
Aldao, A., Sheppes, G., & Gross, J. J. (2015). Emotion regulation flexibility. Cognitive Therapy and Research, 39(3), 263–278. https://doi.org/10.1007/s10608-014-9662-4.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596.744053.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897. https://doi.org/10.1037/0022-006X.56.6.893.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck depression inventory-II. San Antonio: Psychological Corporation.
Beck, J. G., McNiff, J., Clapp, J. D., Olsen, S. A., Avery, M. L., & Hagewood, J. H. (2011). Exploring negative emotion in women experiencing intimate partner violence: Shame, guilt, and PTSD. Behavior Therapy, 42(4), 740–750. https://doi.org/10.1016/j.beth.2011.04.001.
Becker-Asano, C., Sun, D., Kleim, B., Scheel, C. N., Tuschen-Caffier, B., & Nebel, B. (2011). Outline of an empirical study on the effects of emotions on strategic behavior in virtual emergencies. In S. D’Mello, A. Graessner, B. Schuller & J.-C. Martin (Eds.), Affective computing and intelligent interaction (pp. 508–517). Berlin: Springer. https://doi.org/10.1007/978-3-642-24571-8_64.
Benight, C. C., & Bandura, A. (2004). Social cognitive theory of posttraumatic recovery: The role of perceived self-efficacy. Behaviour Research and Therapy, 42, 1129–1148. https://doi.org/10.1016/j.brat.2003.08.008.
Berntsen, D., & Rubin, D. C. (2006). The centrality of event scale: A measure of integrating a trauma into one’s identity and its relation to post-traumatic stress disorder symptoms. Behaviour Research and Therapy, 44(2), 219–231. https://doi.org/10.1016/J.BRAT.2005.01.009.
Berntson, G. G., Cacioppo, J. T., Binkley, P. F., Uchino, B. N., Quigley, K. S., & Fieldstone, A. (1994). Autonomic cardiac control. III. Psychological stress and cardiac response in autonomic space as revealed by pharmacological blockades. Psychophysiology, 31(6), 599–608.
Blechert, J., Peyk, P., Liedlgruber, M., & Wilhelm, F. H. (2016). ANSLAB: Integrated multichannel peripheral biosignal processing in psychophysiological science. Behavior Research Methods, 48(4), 1528–1545. https://doi.org/10.3758/s13428-015-0665-1.
Blix, I., Solberg, Ø, & Heir, T. (2014). Centrality of event and symptoms of posttraumatic stress disorder after the 2011 Oslo bombing attack. Applied Cognitive Psychology, 28(2), 249–253. https://doi.org/10.1002/acp.2988.
Boden, J. M., Fergusson, D. M., Horwood, L. J., & Mulder, R. T. (2015). The role of peri-traumatic stress and disruption distress in predicting post-traumatic stress disorder symptoms following exposure to a natural disaster. BJPsych Open, 1(01), 81–86. https://doi.org/10.1192/bjpo.bp.115.001180.
Bonanno, G. A., Papa, A., Lalande, K., Westphal, M., & Coifman, K. (2004). The importance of being flexible: The ability to both enhance and suppress emotional expression predicts long-term adjustment. Psychological Science, 15(7), 482–487. https://doi.org/10.1111/j.0956-7976.2004.00705.x.
Bonanno, G. A., Pat-Horenczyk, R., & Noll, J. (2011a). Coping flexibility and trauma: The Perceived Ability to Cope With Trauma (PACT) scale. Psychological Trauma: Theory, Research, Practice, and Policy, 3(2), 117–129. https://doi.org/10.1037/a0020921.
Bonanno, G. A., Westphal, M., & Mancini, A. D. (2011b). Resilience to loss and potential trauma. Annual Review of Clinical Psychology, 7(1), 511–535. https://doi.org/10.1146/annurev-clinpsy-032210-104526.
Bordnick, P. S., Graap, K. M., Copp, H. L., Brooks, J., & Ferrer, M. (2005). Virtual reality cue reactivity assessment in cigarette smokers. CyberPsychology & Behavior, 8(5), 487–492. https://doi.org/10.1089/cpb.2005.8.487.
Boucsein, W. (2012). Electrodermal activity (2nd ed.). New York: Springer.
Bovin, M. J., & Marx, B. P. (2011). The importance of the peritraumatic experience in defining traumatic stress. Psychological Bulletin, 137(1), 47–67. https://doi.org/10.1037/a0021353.
Bradley, M. M., & Lang, P. J. (2000). Measuring emotion: Behavior, feeling, and physiology. In R. D. Lane & L. Nadel (Eds.), Cognitive neuroscience of emotion (pp. 242–276). New York: Oxford University Press.
Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-Analysis of risk factors for post traumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748–766. https://doi.org/10.1037//0022-006X.68.5.748.
Brown, A. D., Antonius, D., Kramer, M., Root, J. C., & Hirst, W. (2010). Trauma centrality and PTSD in veterans returning from Iraq and Afghanistan. Journal of Traumatic Stress, 23(4), 496–499. https://doi.org/10.1002/jts.20547.
Brunet, A., Weiss, D. S., Metzler, T. J., Best, S. R., Neylan, T. C., Rogers, C., et al. (2001). The peritraumatic distress inventory: A proposed measure of PTSD criterion A2. The American Journal of Psychiatry, 158(9), 1480–1485. https://doi.org/10.1176/appi.ajp.158.9.1480.
Bryant, R. A., Creamer, M., O’Donnell, M., Silove, D., & McFarlane, A. C. (2008). A multisite study of initial respiration rate and heart rate as predictors of posttraumatic stress disorder. The Journal of Clinical Psychiatry, 69(11), 1694–1701. https://doi.org/10.4088/JCP.v69n1104.
Bryant, R. A., Harvey, A. G., Guthrie, R. M., & Moulds, M. L. (2000). A prospective study of psychophysiological arousal, acute stress disorder, and posttraumatic stress disorder. Journal of Abnormal Psychology, 109(2), 341–344. https://doi.org/10.1037/0021-843X.109.2.341.
Cacioppo, J. T., Uchino, B. N., & Berntson, G. G. (1994). Individual differences in the autonomic origins of heart rate reactivity: The psychometrics of respiratory sinus arrhythmia and preejection period. Psychophysiology, 31(4), 412–419. https://doi.org/10.1111/j.1469-8986.1994.tb02449.x.
Cheng, C., Kogan, A., & Chio, J. H. M. (2012). The effectiveness of a new, coping flexibility intervention as compared with a cognitive-behavioural intervention in managing work stress. Work and Stress, 26(3), 272–288. https://doi.org/10.1080/02678373.2012.710369.
Clark, I. A., Mackay, C. E., & Holmes, E. A. (2015). Low emotional response to traumatic footage is associated with an absence of analogue flashbacks: An individual participant data meta-analysis of 16 trauma film paradigm experiments. Cognition & Emotion, 29(4), 702–713. https://doi.org/10.1080/02699931.2014.926861.
Cohen, J. (1988). Statistical power analysis for the behavioural sciences (2nd ed.). Hillsdale: Lawrence Earlbaum Associates.
Courtney, C. G., Dawson, M. E., Schell, A. M., Iyer, A., & Parsons, T. D. (2010). Better than the real thing: Eliciting fear with moving and static computer-generated stimuli. International Journal of Psychophysiology, 78(2), 107–114. https://doi.org/10.1016/j.ijpsycho.2010.06.028.
Critchley, H. D. (2002). Review: Electrodermal responses: What happens in the brain. The Neuroscientist, 8(2), 132–142. https://doi.org/10.1177/107385840200800209.
Cunningham, K. C., Davis, J. L., Wilson, S. M., & Resick, P. A. (2017). A relative weights comparison of trauma-related shame and guilt as predictors of DSM-5 posttraumatic stress disorder symptom severity among US veterans and military members. British Journal of Clinical Psychology. https://doi.org/10.1111/bjc.12163.
Cuperus, A. A., Klaassen, F., Hagenaars, M. A., & Engelhard, I. M. (2017). A virtual reality paradigm as an analogue to real-life trauma: Its effectiveness compared with the trauma film paradigm. European Journal of Psychotraumatology, 8(Suppl 1), 1338106. https://doi.org/10.1080/20008198.2017.1338106.
Dibbets, P., & Schulte-Ostermann, M. A. (2015). Virtual reality, real emotions: A novel analogue for the assessment of risk factors of post-traumatic stress disorder. Frontiers in Psychology, 6, 681. https://doi.org/10.3389/fpsyg.2015.00681.
Dunmore, E., Clark, D. M., & Ehlers, A. (2001). A prospective investigation of the role of cognitive factors in persistent Posttraumatic Stress Disorder (PTSD) after physical or sexual assault. Behaviour Research and Therapy, 39(9), 1063–1084. https://doi.org/10.1016/S0005-7967(00)00088-7.
Ehlers, A. (2002). Processing styles questionnaire.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319–345. https://doi.org/10.1016/S0005-7967(99)00123-0.
Ehlers, A., Mayou, R. A., & Bryant, B. (1998). Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. Journal of Abnormal Psychology, 107(3), 508–519. https://doi.org/10.1037/0021-843X.107.3.508.
Foa, E. B., Cashman, L., Jaycox, L., & Perry, K. (1997). The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale. Psychological Assessment, 9(4), 445–451. https://doi.org/10.1037/1040-3590.9.4.445.
Franke, G. H. (2000). Brief Symptom Inventory (BSI). Göttingen: Beltz Test GmbH.
Gaggioli, A., Pallavicini, F., Morganti, L., Serino, S., Scaratti, C., Briguglio, M., et al. (2014). Experiential virtual scenarios with real-time monitoring (interreality) for the management of psychological stress: A block randomized controlled trial. Journal of Medical Internet Research, 16(7), e167. https://doi.org/10.2196/jmir.3235.
Galatzer-Levy, I. R., Burton, C. L., & Bonanno, G. A. (2012). Coping flexibility, potentially traumatic life events, and resilience: A prospective study of college student adjustment. Journal of Social and Clinical Psychology, 31(6), 542–567.
Gandubert, C., Scali, J., Ancelin, M.-L., Carrière, I., Dupuy, A.-M., Bagnolini, G., et al. (2016). Biological and psychological predictors of posttraumatic stress disorder onset and chronicity. A one-year prospective study. Neurobiology of Stress, 3, 61–67. https://doi.org/10.1016/j.ynstr.2016.02.002.
García-Campayo, J., del Hoyo, Y. L., Valero, M. S., Yus, M. C. P., Esteban, E. A., Guedea, M. P., et al. (2015). Primary prevention of anxiety disorders in primary care: A systematic review. Preventive Medicine, 76, S12–S15. https://doi.org/10.1016/j.ypmed.2014.10.015.
Garnefski, N., & Kraaij, V. (2007). The Cognitive Emotion Regulation Questionnaire. European Journal of Psychological Assessment, 23(3), 141–149. https://doi.org/10.1027/1015-5759.23.3.141.
Hair, J. F., Black, W. C., Babin, B. J., & Anders, R. E. (2010). Multivariate data analysis: A global perspective (7th ed.). Upper Saddle River: Pearson.
Halligan, S. L., Clark, D. M., & Ehlers, A. (2002). Cognitive processing, memory, and the development of PTSD symptoms: Two experimental analogue studies. Journal of Behavior Therapy and Experimental Psychiatry, 33(2), 73–89. https://doi.org/10.1016/S0005-7916(02)00014-9.
Halligan, S. L., Michael, T., Clark, D. M., & Ehlers, A. (2003). Posttraumatic stress disorder following assault: The role of cognitive processing, trauma memory, and appraisals. Journal of Consulting and Clinical Psychology, 71(3), 419–431. https://doi.org/10.1037/0022-006X.71.3.419.
Hansen, M., Armour, C., Wittmann, L., Elklit, A., & Shevlin, M. (2014). Is there a common pathway to developing ASD and PTSD symptoms? Journal of Anxiety Disorders, 28(8), 865–872. https://doi.org/10.1016/J.JANXDIS.2014.09.019.
Held, P., Owens, G. P., Monroe, J. R., & Chard, K. M. (2017). Increased mindfulness skills as predictors of reduced trauma-related guilt in treatment-seeking Veterans. Journal of Traumatic Stress, 30(4), 425–431. https://doi.org/10.1002/jts.22209.
Hinrichs, R., van Rooij, S., Michopoulos, V., Rothbaum, B., & Ressler, K. (2018). Skin conductance response in the emergency department predicts future PTSD symptom severity. Biological Psychiatry, 83(9), S143. https://doi.org/10.1016/j.biopsych.2018.02.374.
Hinz, A., Seibt, R., Hueber, B., & Schreinicke, G. (2000). Response specificity in psychophysiology. Journal of Psychophysiology, 14(2), 115–122. https://doi.org/10.1027//0269-8803.14.2.115.
Jänig, W., & Häbler, H. J. (2000). Specificity in the organization of the autonomic nervous system: A basis for precise neural regulation of homeostatic and protective body functions. Progress in Brain Research, 122, 351–367.
Kinateder, M., Ronchi, E., Nilsson, D., Kobes, M., Müller, M., Pauli, P., et al. (2014). Virtual reality for fire evacuation research. In A. Krasuski & G. Rein (Eds.), Federated conference on computer science and information systems. (pp. 313–321). New York: IEEE. https://doi.org/10.15439/2014F94.
Kreibig, S. D. (2010). Autonomic nervous system activity in emotion: A review. Biological Psychology, 84(3), 394–421. https://doi.org/10.1016/J.BIOPSYCHO.2010.03.010.
Laposa, J. M., & Alden, L. E. (2008). The effect of pre-existing vulnerability factors on a laboratory analogue trauma experience. Journal of Behavior Therapy and Experimental Psychiatry, 39(4), 424–435. https://doi.org/10.1016/j.jbtep.2007.11.002.
Laposa, J. M., & Rector, N. A. (2012). The prediction of intrusions following an analogue traumatic event: Peritraumatic cognitive processes and anxiety-focused rumination versus rumination in response to intrusions. Journal of Behavior Therapy and Experimental Psychiatry, 43(3), 877–883. https://doi.org/10.1016/j.jbtep.2011.12.007.
Laux, L., Glanzmann, P., Schaffner, P., & Spielberger, C. (1981). Das State-Trait-Angstinventar (STAI) [State-Trait-Anxiety Inventory (STAI)]. Weinheim: Beltz.
Lazarus, R. S. (1993). The emotions: A history of changing outlooks. Annual Review of Psychology, 44(1), 1–21. https://doi.org/10.1146/annurev.ps.44.020193.000245.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer Publishing Company.
LeBlanc, V. R., Regehr, C., Birze, A., King, K., Scott, A. K., MacDonald, R., et al. (2011). The association between posttraumatic stress, coping, and acute stress responses in paramedics. Traumatology, 17(4), 10–16. https://doi.org/10.1177/1534765611429078.
Lee, D. A., Scragg, P., & Turner, S. (2001). The role of shame and guilt in traumatic events: A clinical model of shame-based and guilt-based PTSD. British Journal of Medical Psychology, 74(4), 451–466. https://doi.org/10.1348/000711201161109.
Lesage, F.-X., Berjot, S., & Deschamps, F. (2012). Clinical stress assessment using a visual analogue scale. Occupational Medicine, 62(8), 600–605. https://doi.org/10.1093/occmed/kqs140.
Leskela, J., Dieperink, M., & Thuras, P. (2002). Shame and posttraumatic stress disorder. Journal of Traumatic Stress, 15(3), 223–226. https://doi.org/10.1023/A:1015255311837.
Leung, S.-O. (2011). A comparison of psychometric properties and normality in 4-, 5-, 6-, and 11-point likert scales. Journal of Social Service Research, 37(4), 412–421. https://doi.org/10.1080/01488376.2011.580697.
Loch, N., Hiller, W., & Witthöft, M. (2011). Der cognitive emotion regulation questionnaire (CERQ). Erste teststatistische Überprüfung einer deutschen Adaption. Zeitschrift fur Klinische Psychologie und Psychotherapie, 40(2), 94–106.
Logan, S., & O’Kearney, R. (2012). Individual differences in emotionality and peri-traumatic processing. Journal of Behavior Therapy and Experimental Psychiatry, 43(2), 815–822. https://doi.org/10.1016/J.JBTEP.2011.12.003.
Maercker, A., & Schützwohl, M. (1998). Erfassung von psychischen Belastungssfolgen: Die impact of event Skala—Revidierte Version. Diagnostica, 44, 130–141.
Margraf, J., & Ehlers, A. (2007). Beck Angst-Inventar (BAI). Frankfurt am Main: Harcourt Test Services GmbH.
Mathews, A. (1990). Why worry? The cognitive function of anxiety. Behaviour Research and Therapy, 28(6), 455–468. https://doi.org/10.1016/0005-7967(90)90132-3.
Matthieu, M., Lewis, S. J., Ivanoff, A., & Conroy, K. (2007). School of social work disaster response following the world trade center disaster: MSW student and field instructor perspectives. Brief Treatment and Crisis Intervention, 7(2), 115–126. https://doi.org/10.1093/brief-treatment/mhm003.
Mc Farlane, A. C. (2000). Posttraumatic stress disorder: A model of the longitudinal course and the role of risk factors. The Journal of Clinical Psychiatry, 61(5), 15–20.
McLaughlin, K. a., Borkovec, T. D., & Sibrava, N. J. (2007). The effects of worry and rumination on affect states and cognitive activity. Behavior Therapy, 38(1), 23–38. https://doi.org/10.1016/j.beth.2006.03.003.
Meiser-Stedman, R., Dalgleish, T., Glucksman, E., Yule, W., & Smith, P. (2009). Maladaptive cognitive appraisals mediate the evolution of posttraumatic stress reactions: A 6-month follow up of child and adolescent assault and motor vehicle accident survivors. Journal of Abnormal Psychology, 118, 778.
Mennin, D. S., & Fresco, D. M. (2013). What, me worry and ruminate about DSM-5 and RDoC? The importance of targeting negative self-referential processing. Clinical Psychology: Science and Practice, 20(3), 258–267. https://doi.org/10.1111/cpsp.12038.
Michael, T., & Ehlers, A. (2007). Enhanced perceptual priming for neutral stimuli occurring in a traumatic context: Two experimental investigations. Behaviour Research and Therapy, 45(2), 341–358. https://doi.org/10.1016/j.brat.2006.03.012.
Michael, T., Halligan, S. L., Clark, D. M., & Ehlers, A. (2007). Rumination in posttraumatic stress disorder. Depression and Anxiety, 24(5), 307–317. https://doi.org/10.1002/da.20228.
Munyan, B. G., Neer, S. M., Beidel, D. C., Jentsch, F., Sayer, N., & Nugent, S. (2016). Olfactory stimuli increase presence in virtual environments. PLoS ONE, 11(6), e0157568. https://doi.org/10.1371/journal.pone.0157568.
Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3(5), 400–424. https://doi.org/10.1111/j.1745-6924.2008.00088.x.
O’Donnell, M. L., Elliott, P., Lau, W., & Creamer, M. (2007). PTSD symptom trajectories: From early to chronic response. Behaviour Research and Therapy, 45(3), 601–606. https://doi.org/10.1016/j.brat.2006.03.015.
Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129(1), 52–73. https://doi.org/10.1037/1942-9681.S.1.3.
Pinciotti, C. M., Seligowski, A. V., & Orcutt, H. K. (2017). Psychometric properties of the PACT scale and relations with symptoms of PTSD. Psychological Trauma: Theory, Research, Practice, and Policy, 9(3), 362–369. https://doi.org/10.1037/tra0000206.
Pineles, S. L., Suvak, M. K., Liverant, G. I., Gregor, K., Wisco, B. E., Pitman, R. K., et al. (2013). Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis. Journal of Abnormal Psychology, 122(3), 635–644. https://doi.org/10.1037/a0033942.
Power, M. J., & Fyvie, C. (2013). The role of emotion in PTSD: Two preliminary studies. Behavioural and Cognitive Psychotherapy, 41(02), 162–172. https://doi.org/10.1017/S1352465812000148.
Regambal, M. J., & Alden, L. E. (2009). Pathways to intrusive memories in a trauma analogue paradigm: A structural equation model. Depression and Anxiety, 26(2), 155–166. https://doi.org/10.1002/da.20483.
Resick, P. A., & Miller, M. W. (2009). Posttraumatic stress disorder: Anxiety or traumatic stress disorder? Journal of Traumatic Stress, 22(5), 384–390. https://doi.org/10.1002/jts.20437.
Ripley, A. J., Clapp, J. D., & Beck, J. G. (2017). A prospective examination of risk factors in the development of intrusions following a trauma analog. Behaviour Research and Therapy, 94, 71–80. https://doi.org/10.1016/J.BRAT.2017.05.001.
Rizvi, S., Kaysen, D., Gutner, C., Griffin, M. G., & Resick, P. a. (2008). The role of peritraumatic responses in posttraumatic stress female crime victims. Journal of Interpersonal Violence, 23(6), 853–868. https://doi.org/10.1177/0886260508314851.
Rodin, R., Bonanno, G. A., Knuckey, S., Satterthwaite, M. L., Hart, R., Joscelyne, A., et al. (2017). Coping flexibility predicts post-traumatic stress disorder and depression in human rights advocates. International Journal of Mental Health, 46(4), 327–338. https://doi.org/10.1080/00207411.2017.1345047.
Rovira, A., Swapp, D., Spanlang, B., & Slater, M. (2009). The use of virtual reality in the study of people’s responses to violent incidents. Frontiers in Behavioral Neuroscience, 3(December), 1–10. https://doi.org/10.3389/neuro.08.059.2009.
Rubin, D. C., Berntsen, D., & Bohni, M. K. (2008). A memory-based model of posttraumatic stress disorder: Evaluating basic assumptions underlying the PTSD diagnosis. Psychological Review, 115(4), 985–1011. https://doi.org/10.1037/a0013397.
Schmitt, M., Altstötter-Gleich, C., Hinz, A., Maes, J., & Brähler, E. (2006). Normwerte für das Vereinfachte Beck-Depressions-Inventar (BDI-V) in der Allgemeinbevölkerung. Diagnostica, 52(2), 51–59. https://doi.org/10.1026/0012-1924.52.2.51.
Schmitt, M., Beckmann, M., Dusi, D., Maes, J., Schiller, A., & Schonauer, K. (2003). Messgüte des vereinfachten Beck-Depressions-Inventars (BDI-V). Diagnostica, 49(4), 147–156. https://doi.org/10.1026//0012-1924.49.4.147.
Schmitt, M., & Maes, J. (2000). Vorschlag zur Vereinfachung des Beck-Depressions-Inventars (BDI). Diagnostica, 46(1), 38–46. https://doi.org/10.1026//0012-1924.46.1.38.
Schubert, T. (2003). The sense of presence in virtual environments: A three-component scale measuring spatial presence, involvement, and realness. Zeitschrift Für Medienpsychologie, 15(2), 69–71. https://doi.org/10.1026//1617-6383.15.2.69.
Schubert, T., Friedmann, F., & Regenbrecht, H. (2001). The experience of presence: Factor analytic insights. Presence, 10(3), 266–281.
Schumm, J. A., Dickstein, B. D., Walter, K. H., Owens, G. P., & Chard, K. M. (2015). Changes in posttraumatic cognitions predict changes in posttraumatic stress disorder symptoms during cognitive processing therapy. Journal of Consulting and Clinical Psychology, 83(6), 1161–1166. https://doi.org/10.1037/ccp0000040.
Schweizer, T., Renner, F., Sun, D., Kleim, B., Holmes, E., & Tuschen-Caffier, B. (2018). Psychophysiological reactivity, coping behaviour and intrusive memories upon multisensory Virtual Reality and Script-driven imagery analogue trauma: A randomised controlled crossover study. Journal of Anxiety Disorders. https://doi.org/10.1016/j.janxdis.2018.08.005 (in press).
Schweizer, T., Schmitz, J., Plempe, L., Sun, D., Becker-Asano, C., Leonhart, R., et al. (2017). The impact of pre-existing anxiety on affective and cognitive processing of a Virtual Reality analogue trauma. PLoS ONE, 12(12), e0190360. https://doi.org/10.1371/journal.pone.0190360.
Seligowski, A. V., Lee, D. J., Bardeen, J. R., & Orcutt, H. K. (2015). Emotion regulation and posttraumatic stress symptoms: A meta-analysis. Cognitive Behaviour Therapy, 44(2), 87–102.
Shahar, G., Noyman, G., Schnidel-Allon, I., & Gilboa-Schechtman, E. (2013). Do PTSD symptoms and trauma-related cognitions about the self constitute a vicious cycle? Evidence for both cognitive vulnerability and scarring models. Psychiatry Research, 205(1–2), 79–84. https://doi.org/10.1016/J.PSYCHRES.2012.07.053.
Shalev, A. Y., Sahar, T., Freedman, S., Peri, T., Glick, N., Brandes, D., et al. (1998). A prospective study of heart rate response following trauma and the subsequent development of posttraumatic stress disorder. Archives of General Psychiatry, 55(6), 553–559. https://doi.org/10.1001/archpsyc.55.6.553.
Shipherd, J. C., Salters-Pedneault, K., Fordiani, J., & Fordiani, J. (2016). Evaluating postdeployment training for coping with intrusive cognition: A comparison of training approaches. Journal of Consulting and Clinical Psychology, 84(11), 960–971. https://doi.org/10.1037/ccp0000136.
Soeter, M., & Kindt, M. (2013). High trait anxiety: A challenge for disrupting fear memory reconsolidation. PLoS ONE, 8(11), e75239. https://doi.org/10.1371/journal.pone.0075239.
Solberg, Ø, Birkeland, M. S., Blix, I., Hansen, M. B., & Heir, T. (2016). Towards an exposure-dependent model of post-traumatic stress: Longitudinal course of post-traumatic stress symptomatology and functional impairment after the 2011 Oslo bombing. Psychological Medicine, 46(15), 3241–3254. https://doi.org/10.1017/S0033291716001860.
Soper, D. S. (2018). A-priori sample size calculator for hierarchical multiple regression [software]. Retrieved February 12, 2018, from http://www.danielsoper.com/statcalc.
Spielberger, C. D., Gorsuch, R. L., Lushene, P. R., Vagg, P. R., & Jacobs, A. G. (1983). Manual for the state-trait anxiety inventory (STAI). Palo Alto: Consulting Psychologists Press.
Thomas, É, Saumier, D., & Brunet, A. (2012). Peritraumatic distress and the course of posttraumatic stress disorder symptoms: A meta-analysis. The Canadian Journal of Psychiatry, 57(2), 122–129. https://doi.org/10.1177/070674371205700209.
Weidmann, A., Conradi, A., Groger, K., Fehm, L., & Fydrich, T. (2009). Using stressful films to analyze risk factors for PTSD in analogue experimental studies—Which film works best? Anxiety, Stress, and Coping, 22(5), 549–569. https://doi.org/10.1080/10615800802541986.
Weiss, D. S., & Marmar, C. R. (1997). The Impact of Event Scale-Revised (IES-R). In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399–411). New York: Guilford Press.
Wilhelm, F. H., & Peyk, P. (2005). ANSLAB: Autonomic Nervous System Laboratory 4.0 [Computer Software]. Basel: Wilhelm & Peyk.
Woud, M. L., Holmes, E. A., Postma, P., Dalgleish, T., & Mackintosh, B. (2012). Ameliorating intrusive memories of distressing experiences using computerized reappraisal training. Emotion, 12(4), 778–784. https://doi.org/10.1037/a0024992.
Woud, M. L., Postma, P., Holmes, E. A., & MacKintosh, B. (2013). Reducing analogue trauma symptoms by computerized reappraisal training-Considering a cognitive prophylaxis? Journal of Behavior Therapy and Experimental Psychiatry, 44(3), 312–315. https://doi.org/10.1016/j.jbtep.2013.01.003.
Acknowledgements
The development of the alpha version of the VR scenario was funded by the Freiburg Institute for Advanced Studies (FRIAS; project leader: B. Tuschen-Caffier & B. Nebel).
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T. Schweizer, Fritz Renner, Dali Sun, Christian Becker-Asano and Brunna Tuschen-Caffier declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Schweizer, T., Renner, F., Sun, D. et al. Cognitive Processing and Regulation Modulates Analogue Trauma Symptoms in a Virtual Reality Paradigm. Cogn Ther Res 43, 199–213 (2019). https://doi.org/10.1007/s10608-018-9967-9
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DOI: https://doi.org/10.1007/s10608-018-9967-9