A longitudinal investigation of the relationships among PTSD symptoms and various cognitive biases in children and adolescents

Background: Cognitive biases have been implicated in PTSD, whereas the dynamic interactions of various cognitive biases remain understudied. This study aimed to investigate the prospective associations among biases of negative appraisals, attention for threat, belief inflexibility, and jumping to conclusions, and further examine the bidirectional relationships of PTSD symptoms and different types of biases.
Method: A total of 1549 children and adolescents (52.6% % male; mean age 13.66 years, SD = 1.24, range from 11.00 to 17.00) who exposed to various types of trauma were surveyed at baseline and follow-up interval one year by using self-report questionnaires. Cross-lagged model was used to examine significant associations by path analyses.
Results: Negative appraisals, attention for threat and PTSD symptoms could predict and be predicted each other prospectively. There were no significant prospective associations among attention for threat, belief inflexibility, and jumping to conclusions, although with high concurrent relationships of the variables. Baseline PTSD symptoms and negative appraisals were also associated with increased belief inflexibility at follow-up.
Conclusions: Our findings indicate vicious circle of negative appraisals, attention for threat and PTSD symptoms in trauma-exposed children and adolescents. Negative appraisals and attention for threat play important roles in development and maintenance of PTSD and its related cognitive biases. Combination of different types of cognitive bias modification would help the treatment and prevention of PTSD.