Elsevier

Behavior Therapy

Volume 47, Issue 3, May 2016, Pages 388-403
Behavior Therapy

Cognitive Load Undermines Thought Suppression in Acute Stress Disorder☆

https://doi.org/10.1016/j.beth.2016.02.010Get rights and content

Highlights

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    Examined suppression and cognitive load in recent trauma victims

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    Individuals with ASD under load conditions experienced more intrusions

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    Individuals with ASD under load conditions showed recall bias for certain negative stimuli

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    Findings suggest that cognitive load interferes with suppression ability

Abstract

Thought suppression studies demonstrate that attempts to suppress can be undermined by cognitive load. We report the first instance in which this has been tested experimentally in a sample of recently traumatized individuals. Individuals with and without acute stress disorder (ASD) were recruited following recent trauma and randomized to load or no load conditions (N = 56). They monitored intrusive memories during baseline, suppression, and think anything phases. The impact of suppression and load on self-reported intrusions, attention bias (dot-probe), and memory priming (word-stem task) was assessed. The ASD load group were less able to suppress memories (d = 0.32, CI95 [− 0.15, 0.83], p = .088) than the ASD no load group (d = 0.63, CI95 [0.08, 1.24], p < .001). In the think anything phase, the ASD load group reported more intrusions than the ASD no load or non-ASD groups (with and without load). No consistent findings were observed in relation to attentional bias. ASD load individuals exhibited stronger priming responses for motor vehicle accident and assault words than all other groups (ds between 0.35–0.73). Working memory did not moderate any outcomes of interest. The findings indicate that cognitive load interferes with suppression and may enhance access to trauma memories and associated material. The study extends previous research by demonstrating these effects for the first time in a clinical sample of recent survivors of trauma.

Section snippets

Participants

Participants were 56 adults who were recruited from the local hospital following admission after a traumatic event (e.g., MVA, assault, etc., see Table 1 for participant details and trauma characteristics). Of the 68 considered, 4 met exclusion criteria (e.g., not fluent in English, significant head injury, or current risk due to suicidality/homicidality/psychosis), 5 could not complete the assessment (session interrupted, discharged) and data was not used from 3 due to validity concerns (e.g.,

Covariates and Manipulation Checks

As seen in Table 1, only a few variables showed potential meaningful differences (in terms of ESs) between groups, including current rating of pain, LOC, prior hospitalization for psychiatric reasons and number of treatment sessions before the trauma. The impacts of these on the 10 main DVs of interest (intrusions, dot-probe and word-stem) were minimal. At most, each variable only correlated with 2 of the 10 variables at r = .20 (i.e., only 4% variance explained), with the exception of LOC. Over

Discussion

This study is the first time the proposal that cognitive load might undermine suppression performance has been directly tested in an acute sample of survivors of trauma with and without ASD. We detail both the explicit and implicit consequences below, while offering explanations for some unexpected findings.

Our hypothesis that under conditions of cognitive load individuals with ASD would have difficulties suppressing relative to the other groups was supported. Of particular interest is that

Conflict of Interest Statement

The authors declare that there are no conflicts of interest.

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    ☆

    This research was supported by an Australian Research Council Discovery Project grant awarded to the first author (DP0557070). The granting body had no role in the design, collection, analysis or interpretation of the data, or submission of the manuscript. We thank the participants who contributed their time to the study and Paul Williamson for his comments on an earlier draft.

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