Perturbed threat monitoring following a traumatic event predicts risk for post-traumatic stress disorder

R. Naim*, I. Wald, A. Lior, D. S. Pine, N. A. Fox, G. Sheppes, P. Halpern, Y. Bar-Haim

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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. Method 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.

Original languageEnglish
Pages (from-to)2077-2084
Number of pages8
JournalPsychological Medicine
Issue number10
StatePublished - Jul 2014


  • Anxiety
  • Attention bias
  • Dissociation
  • PTSD


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