(PS4-C59) Those Who Seek Reminders of Trauma: High Prevalence of Self-triggering Behavior in a PTSD Clinical Sample

Introduction: Avoidance of trauma-related stimuli is one of the DSM-5 criteria for a diagnosis of PTSD. Yet there is growing evidence that some trauma survivors actively seek out reminders of their trauma outside of a therapeutic context (e.g., reading books, watching videos, or seeking interpersonal situations reminiscent of trauma), a phenomenon known as “self-triggering.” Although prior studies have demonstrated that self-triggering is present in a non-trivial number of individuals with PTSD, there has been no analysis of the prevalence of self-triggering in a clinical sample. It also remains unclear if any clinically relevant differences exist for individuals who self-trigger compared to those who do not. The aims of the present study were to (a) estimate the prevalence of self-triggering behavior among individuals seeking treatment for PTSD; and (b) explore differences between individuals with PTSD who do and do not self-trigger.



Method: We examined data from a sample of adults with clinically diagnosed PTSD seeking treatment at an outpatient anxiety and trauma clinic (N = 56) at an academic medical center. All patients completed psychological self-report questionnaires as part of their clinical evaluation. For Aim 1, we calculated the percentage of individuals who reported self-triggering on the self-triggering questionnaire. For Aim 2, we examined self-report measures of PTSD (PCL-5), anxiety (GAD-7, OASIS, PDSS, SSASI), depression (VQIDS), and personality/functioning (QLESQ, TIPI). We conducted t-tests to determine if there were differences in scores between those who self-trigger and those who do not. For t-tests that yielded significant or nearly significant results, Spearman’s correlations were calculated to determine if there was a relationship between self-triggering frequency and the score of the measure of interest.



Results: Almost half of our sample (n = 25, 44.6%) endorsed self-triggering behavior. Participants who self-triggered reported a mean frequency of 2-3 times over the past month. There were no significant differences in PTSD severity, depression severity, or personality/functioning scores between those who self-trigger and those who do not. There was a weak correlation between frequency of self-triggering behavior and anxiety sensitivity (r(54) = 0.30, p = 0.024). There were no other significant differences between those who do and do not self-trigger.

Discussion: In this first examination of self-triggering in a clinical sample, a substantial number of PTSD patients reported that they have actively sought reminders of their trauma outside of a therapeutic context. These findings suggest self-triggering is a clinically relevant yet underexamined component of PTSD. Analysis of self-report questionaries revealed that those who self-triggered were largely similar to those who did not, though these findings should be interpreted with caution given the small sample size and potential ceiling effects on symptom measures. Further research should explore whether self-triggering moderates PTSD treatment outcome, which could inform more tailored clinical interventions.