Abstract
Emotional future thinking serves important functions related to goal pursuit and emotion regulation but has been scantly studied in posttraumatic stress disorder (PTSD). The current study sought to characterize emotional future thinking in PTSD and to identify clinical and neurocognitive profiles associated with potential alterations in the level of detail in narratives of imagined future events. Fifty-eight, trauma-exposed, war-zone veterans, who were classified into current PTSD, past PTSD, and no-PTSD groups, were asked to vividly imagine future events in response to positive and negative cue words occurring in the near and distant future. These narratives were scored for internal (i.e., pertaining to the main event) and external (i.e., tangential to the main event) details. Participants also performed neurocognitive tasks of generative ability, working memory, and relational verbal memory. Linear mixed modeling revealed that the current and past PTSD groups generated fewer internal details than the no-PTSD group across positive and negative cue words and across temporal proximity. Partial least squares analysis revealed that symptom severity for all PTSD clusters was inversely associated with production of internal details, albeit with the association relatively weaker for intrusion symptoms. Among the neurocognitive tasks, only relational verbal memory was associated with production of internal details. These findings suggest, as predicted, that functional avoidance may underlie reduced detail generation but also point to potential additional mechanisms to be further investigated. That future event simulation remains overgeneral even when PTSD symptoms abate highlights the importance of addressing alterations in future thinking in this population.
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01 December 2023
A Correction to this paper has been published: https://doi.org/10.3758/s13415-023-01141-0
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Author note
We have no known conflicts of interest to disclose. This research was supported by grant I01 CX001596 and a Senior Career Scientist Award (to MV) from the Clinical Sciences Research and Development Service, Department of Veterans Affairs. The authors thank Dr. Daniela Palombo for valuable help during study development and Dominoe Jones and Caroline Strang for research assistance. The contents of this manuscript do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.
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Appendix
Supplementary PLS analyses
To examine whether associations between types of internal details (y-variables) and PTSD symptom clusters, Future Time Perspective scores, and neurocognitive performances (x-variables) differed depending on whether PTSD symptoms were expressed currently or in the past, we performed two separate PLS analyses, one including participants in the PTSDcurrent and no-PTSD groups, the second including participants in the PTSDpast and no-PTSD groups. Current PTSD symptom scores were entered for the PTSDcurrent group and past symptoms during their most symptomatic period for the PTSDpast group.
PTSDcurrent and no-PTSD
Results revealed a significant association among the variables (inertia = 2.9, p = .026), which was best explained by one latent variable (eigenvalue = 2.34, p < .001) that accounted for 79.6% of the variables’ covariance. Among the y-variables, types of internal details categorized as event, place, and perceptual details were found to be reliable contributors (salience to standard error ratios: z = 2.4, 3.0, and 2.6, respectively). By contrast, time and thought/emotion details were not found to be reliable contributors (z = -0.4 and 0.6, respectively). Among the x-variables, all CAPS-5 subscales were inversely associated with production of internal details. Contributions were reliable for scores on the avoidance subscale (z = -3.0) and NACM subscale (z = -2.0). Scores on the arousal and intrusion subscales were below the reliability threshold (z = -1.6 and -1.5, respectively). Among the Future Time Perspective scales, only future value contributed reliably and positively to the latent variable (z = 4.1). Contributions of future connectedness (z = 0.1), speed (z = -0.6) and future extension (z = -1.0) were not reliable. Among neurocognitive measures, the only measure that reliably contributed to the latent variable was Paired Associates delayed recall (z = 2.5). Contributions of FAS fluency (z = 1.1), Letter-Number Sequencing (z = 1.1), Paired Associates immediate recall (z = 1.3), Digit Span forward (z = 0.5), and Digit Span backward (z = 0.8) were below the reliability threshold.
PTSDpast and no-PTSD
Results revealed a significant association among the variables (inertia = 4.5, p, <.001), which was best explained by one latent variable (eigenvalue = 3.95, p < .001) that accounted for 87.4% of the variables’ covariance. Among the y-variables, types of internal details categorized as event, place, time, and perceptual details were found to be reliable contributors (salience to standard error ratios: z = 2.7, 3.9, 2.2 and 2.8, respectively). By contrast, thought/emotion details were not found to be reliable contributors (z = 1.3). Among the x-variables, all CAPS-5 subscales were inversely associated with production of internal details. Contributions were reliable for scores on the avoidance (z = -2.0), NACM (z = -2.5) and arousal subscales (z = -2.1). Scores on the intrusion subscale were below the reliability threshold (z = -1.8). Among the Future Time Perspective scales, only future value contributed reliably and positively to the latent variable (z = 2.0). Contributions of future connectedness (z = 1.0), speed (z = 0.5) and future extension (z = 0.4) were not reliable. Among neurocognitive measures, Paired Associates immediate recall (z = 2.2) and delayed recall (z = 2.0) made reliable and positive contributions to the latent variable. Contributions of FAS fluency (z = 1.5), Letter-Number Sequencing (z = 1.6), Digit Span forward (z = 0.3), and Digit Span backward (z = 1.3) were below the reliability threshold.
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Verfaellie, M., Patt, V., Lafleche, G. et al. Imagining emotional future events in PTSD: clinical and neurocognitive correlates. Cogn Affect Behav Neurosci 23, 1428–1444 (2023). https://doi.org/10.3758/s13415-023-01121-4
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DOI: https://doi.org/10.3758/s13415-023-01121-4