The impact of pre-existing anxiety on affective and cognitive processing of a Virtual Reality analogue trauma

Dysfunctional processing of traumatic events may be in particular related to high trait anxiety as a pre-traumatic risk factor for the development of post-traumatic stress disorder (PTSD). However, as this has rarely been investigated in prospective, experimental studies, we aimed to analyse the association between high trait anxiety and affective as well as cognitive processing of stress using a new prospective Virtual Reality analogue trauma paradigm to overcome limitations of retrospective or current analogue designs. Individuals with high and low trait anxiety (N = 80) were exposed to a multi-sensory Virtual Reality emergency scenario while psychophysiological stress response, emotion regulation and intrusive memories were assessed. Our results showed that high trait anxiety individuals display increased (i) subjective stress responses, (ii) emotion dysregulation and (iii) intrusive memories upon VR analogue trauma exposure. In particular, our sample of high trait anxiety individuals displayed limited access to different emotion regulation strategies as well as increased worry and rumination regarding perceived intrusive memories. Considering the complex interplay of multiple risk factors, our findings suggests that peri-traumatic affective processing seems to mediate high trait anxiety and post-traumatic intrusive memories thereby pointing out the central role of peri-traumatic processes for intrusion development. In addition, HA as a modulating pre-traumatic risk factor might further increase the risk of later dysfunctional processing of an analogue trauma by interacting with factors of affective processing during analogue trauma exposure. Implications of these findings which may contribute to a higher risk to develop PTSD are discussed.创伤事件的异常加工，或与作为创伤后应激障碍（PTSD）发病的创伤前风险因子的高特质焦虑存在特异性关联。然而，此前鲜有前瞻性实验研究对此展开探讨，本研究旨在借助一种新型前瞻性虚拟现实（Virtual Reality, VR）模拟创伤范式，剖析高特质焦虑与应激的情感及认知加工之间的关联，以弥补回顾性范式与现有模拟范式的局限性。本研究招募高低特质焦虑个体共80名，令其暴露于多感官虚拟现实应急场景中，同时评估其心理生理应激反应、情绪调节能力与闯入性记忆水平。研究结果显示，高特质焦虑个体在虚拟现实模拟创伤暴露过程中，呈现出三方面增强的表现：其一为主观应激反应加剧，其二为情绪调节失调，其三为闯入性记忆增多。具体而言，本研究中的高特质焦虑个体，难以调用多种情绪调节策略，且针对感知到的闯入性记忆表现出更显著的担忧与反刍思维。考虑到多种风险因子间存在复杂的交互作用，本研究结果表明，创伤期间的情感加工似乎在高特质焦虑与创伤后闯入性记忆之间发挥中介效应，由此凸显了创伤期间加工过程在闯入性记忆形成中的核心作用。此外，高特质焦虑（HA）作为一种可调节的创伤前风险因子，或可通过与模拟创伤暴露过程中的情感加工因子产生交互作用，进一步提升个体后续出现模拟创伤异常加工的风险。本研究亦探讨了上述研究结果的启示意义，其或有助于识别PTSD发病风险更高的个体。