(PS4-A1) Effect of Hormonal Contraception on Attentional Bias to Threat Among Individuals with PTSD

Posttraumatic stress disorder (PTSD) is a chronic and disabling disorder that affects a significant proportion of individuals exposed to traumatic events (Liu et al., 2017). Women are more than twice as likely as men to develop PTSD (Koenen et al., 2017). As such, sex-based biological vulnerabilities for the development and maintenance of this disorder warrant further research. Previous research (e.g., Garcia et al., 2018; Li & Graham, 2017) has suggested that one such vulnerability, differences in sex hormone levels, may contribute to the disparity in observed rates of PTSD. However, little research to date has examined the role of hormonal contraceptive (HC) use in the mechanisms underlying the maintenance of PTSD symptoms. To that end, this study examined the relationship of HC use to attentional bias to threat among female survivors of recent (< 12 months) sexual assault between the ages of 18 and 35. Ninety-nine participants recruited via Prolific completed online surveys assessing HC use, lifetime traumatic event exposure, PTSD symptoms, depression and anxiety symptoms, peritraumatic distress, emotion dysregulation, treatment history, reading ability, and demographic information, as well as an behavioral dot probe task assessing attentional bias to general threat words and sexual assault-related words. Hierarchical linear regression analyses were conducted to examine main effects of and interactions between PTSD symptom severity and HC status on attentional bias to general and sexual assault-related threat words. Across analyses, HC demonstrated a significant positive main effect on attentional bias to sexual assault-related words above and beyond relevant covariates (bs = 14.268 – 14.767, ps = 0.011 – 0.014). HC use demonstrated no significant main effect on attentional bias to general threat words (ps > 0.05). There was no evidence of an interaction effect between HC use and PTSD symptoms across models (ps > 0.05). Results suggest that HC use is positively associated with heightened attentional bias to threat for trauma-related cues among a recently trauma-exposed sample. These findings suggest that individuals who use HC may struggle to habituate to trauma-related stimuli compared to those who do not use HC and have important implications for treatments that use fear extinction learning as a primary mechanism of change in PTSD recovery. Future research in this area may benefit from the examination of sex and stress hormone levels among individuals with PTSD symptoms.