The Sky is Falling: Exploring Anticipatory Traumatic Reaction

Abstract

In recent years, the global community has suffered uncertainty and threats to safety due to a variety of events, including terrorist attacks, large-scale accidents, natural disasters, and international conflicts. Indirect engagement with these events is made possible through the media. Numerous studies have found negative psychological outcomes following indirect exposure to trauma, either via media coverage or through care of people directly impacted. If media has the potential to effect even small negative changes in psychological health, then cumulative or more intense exposure might lead to more substantive effects.<br/> This thesis explored whether trauma-related media consumption and ensuing social discussions may trigger a unique form of distress, referred to as Anticipatory Traumatic Reaction (ATR). This construct is based on the dual scaffold of (1) the diagnostic criteria of posttraumatic stress disorder (PTSD) considered sub-clinically and (2) emotions, cognitions, and behaviours that have been associated with secondary exposure to trauma. Specifically, ATR is conceptualised as involving people overestimating future risk (for themselves or significant others) of traumatic events presented in the media and experiencing distress relating to feared outcomes. Affected individuals might engage in thoughts or behaviours designed to reduce uncertainty or prepare for adverse events and experience disruptions in day-to-day functioning.<br/> A total of six studies (reported in the format of five stand-alone articles) were conducted. Study 1 was a quantitative meta-analysis of experimental studies that evaluated the overall effect of threat-related media on psychological outcomes. This study confirmed the association between trauma-related media exposure and negative psychological outcomes and provided evidence to support a causal pathway. Studies 2 and 3 (reported in a single journal article) generated a new psychometric measure to assess the novel construct of ATR and found preliminary evidence of this form of distress in a general population of Australians. Study 2 used exploratory and confirmatory factor analysis to construct a scale with three latent variables (feelings, preparation, and disruptions relating to ATR) and correlational analyses found evidence of convergent and discriminant validity for the scale. Study 3 provided additional validation of the scale, examined links with conceptually related variables pertaining to media consumption, and provided evidence for ATR as a construct that, despite some overlap, is separate and distinct from PTSD. The results also indicated that higher levels of ATR are associated with a greater degree of engagement with threat-related media and social discussions. Further, the results suggested that younger people might be at greater risk of ATR than older people, and that this may be partially accounted for by a greater proportion of social media news-gathering by younger people.<br/> Study 4 explored possible links between ATR and a reaction to another form of secondary exposure to trauma – compassion fatigue, which occurs as a consequence of providing a caring role for traumatised individuals. The results suggested that high levels of ATR may exacerbate levels of depression, anxiety, and stress, potentially putting care workers at greater risk of job burnout. Study 5, a meta-analytic review of the efficacy of mindfulness interventions for treating PTSD, indicated that, across studies, mindfulness was effective in reducing symptoms of PTSD. Given some symptomatic and conceptual similarities between PTSD and ATR, this finding pointed to mindfulness as a potentially useful technique for mitigating ATR. The final study, Study 6, assessed proposed risk factors for ATR and used an online experiment with random assignment to test a series of brief interventions to attenuate ATR. The findings suggested that risk factors for experiencing higher levels of ATR included being female, being younger, living with a mental illness, repetitive negative thinking, intolerance of uncertainty, personal distress empathy, fantasy empathy, and a concern about world politics. Both a cognitive intervention to address probability neglect and a mindfulness intervention showed promise in attenuating momentary ATR.<br/> The current research provides preliminary evidence for ATR as a newly identified psychological condition that may occur for some people in response to media exposure and social discussions of disasters and large-scale threats. If, as suggested by the results of this research, people with existing mental illness are at greater risk for ATR and that ATR might exacerbate existing symptoms, it will be important to identify vulnerable subsets of this population so that clinicians can intervene to reduce ATR and limit distress. Because media exposure to traumatic events is a basis for ATR, the findings have implications for presentation of media content. This thesis adds to the body of knowledge in the fields of trauma, social psychology, and clinical practice.