Leaving the door open: Trauma, updating, and the development of PTSD symptoms

Marie R. Sopp, Shilat Haim-Nachum, Benedikt E. Wirth, George A. Bonanno, Einat Levy-Gigi

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Humans try to make sense of the world using hypotheses that were formed by prior experiences. After trauma, these hypotheses can be exaggerated and resistant to change. This may result in difficulties to update expectations regarding the negative outcomes associated with traumatic stimuli. Critically, it has been proposed that such difficulties may drive the development of posttraumatic stress disorder (PTSD). However, direct evidence on the associations between trauma and impaired expectation updating is still absent. Moreover, it remains unclear whether such an impairment is correlated with PTSD symptoms. To address these gaps, we compared the ability to update traumatic and neutral stimulus-outcome expectations in 81 active-duty firefighters. Participants completed a performance-based updating task and were assessed for PTSD symptoms. We predicted and found a selective impairment in updating trauma-related expectations. This impairment was evident for negative-to-positive but not for positive-to-negative updating. Moreover, impaired negative-to-positive updating was positively associated with PTSD symptoms. These findings support the predictive processing account of PTSD and suggest that strengthening updating processes could be an important goal for promoting resilience after trauma.

Original languageEnglish
Article number104098
JournalBehaviour Research and Therapy
StatePublished - Jul 2022

Bibliographical note

Publisher Copyright:
© 2022 Elsevier Ltd


MRSs participation in this project was supported by a fellowship from the German Academic Exchange Service ( DAAD ). SHN is grateful to the Azrieli Foundation for the award of an Azrieli Fellowship. BEWs participation in this project was supported by a Minerva Fellowship of the Minerva Stiftung Gesellschaft fuer die Forschung mbH. This work was supported by the Binational Science Foundation; BSF (Grant # 2015_143 ) to ELG and GAB.

FundersFunder number
Minerva Stiftung Gesellschaft fuer die Forschung mbH
Deutscher Akademischer Austauschdienst
United States-Israel Binational Science Foundation2015_143
Azrieli Foundation


    • Firefighters
    • High-risk occupations
    • PTSD symptoms
    • Predictive processing
    • Trauma exposure
    • Updating


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