The Lasting Effects of Early Adversity and Updating Ability on the Tendency to Develop PTSD Symptoms Following Exposure to Trauma in Adulthood

Background: Adverse childhood experiences (ACEs) serve as a risk factor for developing posttraumatic stress disorder (PTSD) in those who experience additional adult trauma. However, while some individuals with ACEs develop severe PTSD symptoms following exposure to additional adult trauma, others do not. We propose that updating prior knowledge in the face of new inconsistent information may account for these individual differences. This notion is based on prior work showing that for individuals with a reduced ability to update negative-to-positive outcome associations, greater trauma is correlated with elevated PTSD symptoms. On the other hand, individuals with flexible updating do not develop such symptoms. Objective. Here, we tested whether reduced updating moderates the relationship between ACEs and PTSD symptoms following additional adult trauma. Methods: Firefighters (N = 123, Mage = 28.02, SDage = 4.69) were assessed for childhood adversity and PTSD symptoms and completed a performance-based learning paradigm to evaluate reduced updating. Results: We predicted and found strong associations between ACEs and PTSD symptoms for individuals with reduced updating of negative–but not positive–outcomes. Conclusions: The results may serve as a first step toward improving mental health outcomes in individuals with ACEs and protecting them from the aversive effect of exposure to additional adult trauma.