Context as a barrier: Impaired contextual processing increases the tendency to develop PTSD symptoms across repeated exposure to trauma

Growing evidence links repeated traumatic exposure with impaired ability to process contextual information. Specifically, like individuals with PTSD, non-PTSD trauma-exposed individuals fail to react according to contextual demands. In the present study, we explored the process that underlies this impairment. First, we tested the ability of first responders to benefit from contextual primes to improve recognition. Second, we assessed its moderating role in the relationship between traumatic exposure and PTSD symptoms. Fifty-three active-duty firefighters and 33 unexposed civilians matched for age, gender, and years of education participated in the study. All participants completed the contextual priming paradigm, the CAPS-5 clinical interview, and the WAIS-IV vocabulary subtest and were assessed for depression and general traumatic exposure. Repeated traumatic exposure was assessed objectively using the fire-and-rescue-service tracking system. As predicted, we found that trauma-exposed individuals failed to use primes to facilitate rapid and accurate recognition of contextually related objects. Not only did contextual information not improve performance, but it achieved the opposite effect, manifested as negative priming. Hence, context appeared to be an obstacle for trauma-exposed individuals and delayed rapid and accurate recognition. Moreover, impaired ability to process contextual information predicted the tendency to develop PTSD symptoms across repeated exposure to trauma.