The Impact of Listening to a Trauma Story

Listening to trauma narratives may lead to secondary traumatic stress. Deliberate activation of the prefrontal cortex may buffer the emotional impact of listening to trauma narratives, but to date no study has explored this systematically, whilst controlling for other important psychological and neurobiological variables. The proposed project will examine factors which may protect against secondary traumatic stress.

AIMS AND OBJECTIVES
People exposed vicariously to trauma (e.g., listening to a victim of an assault relate their traumatic experience), can develop related intrusive imagery or secondary traumatic stress (STS)1, with symptoms similar to posttraumatic stress disorder (PTSD), i.e., re-experiencing the traumatic event (e.g., via intrusive images), avoiding trauma reminders, having negative feelings and hyperarousal. Human services professionals are at high risk of developing STS. Among those, trauma therapists (e.g., clinical psychologists, psychiatrists, etc.) working closely with survivors of trauma may be particularly at risk. Certain aspects of empathy and clinical work (e.g. perspective-taking, emotion regulation, etc.) could be protective, as they involve increased activity of brain areas [such as the prefrontal cortex (PFC)] that regulates physiological stress response4. There is however debate as to whether empathy buffers the emotional impact of listening to trauma stories, or increases vulnerability2,3. Another related factor that may also mediate the impact of vicarious trauma is attachment style. Secure attachment has been associated with more empathic responses and lower scores of emotional distress after trauma5. In spite of these findings, no study has yet examined the role played by empathy, attachment style and PFC activity during vicarious trauma exposure in the development of secondary traumatic stress.

Furthermore, while research investigating the impact of direct trauma exposure has found an association between PTSD, low cortisol levels, impaired emotion processing and altered activation of brain areas involved in emotion regulation6, the neurobiological alterations associated with listening to trauma narratives are relatively unexplored. In addition, a relevant role may also be played by oxytocin, a hormone involved in socioemotional processing, that has been shown to down-regulate stress activity, reduce anxiety, and increase PFC activity. Still, no study has yet examined the relationship between cortisol and oxytocin released during the exposure to trauma narratives in relation to PFC activity and its effects on STS or intrusive imagery.

The proposed study will explore the relationship between prefrontal cortex activity and hormonal responses (cortisol and oxytocin) induced by listening to trauma stories on the development of intrusive imagery. Furthermore, we will investigate whether performing cognitive tasks while listening to trauma stories (with the purpose of increasing PFC activity) will prevent intrusive imagery. We will also investigate the moderating role played by empathy and attachment, and whether therapists’ (mental health professionals working with those who have mental health difficulties) have increased intrusive imagery following exposure to a narrated trauma story compared to non-therapists.

The study will be the first to examine the relationship between intrusive imagery and: (a) empathy and attachment style, (b) prefrontal cortex activity while listening to a trauma story, and (c) underlying neuroendocrine mechanisms (specifically the role of hormones known to be involved in the regulation of stress and social behaviours, such as cortisol and oxytocin).

IMPACT
The study will identify the key factors (and underlying neurobiological mechanisms) that affect vulnerability and resilience to STS. The findings will have implications for the training of therapists and inform policy and health and safety strategies for professionals whose duties involve listening to trauma stories (e.g., police officers, social workers, solicitors, aid workers, emergency services, volunteers on help telephone lines, etc.). Finally, the project will facilitate publications amongst high-impact factor journals.

PROPOSED SUPERVISORY TEAM
Dr Maria Livanou (Director of Studies)
Dr Daniela di Basilio (1st Supervisor)
Dr Maribel Cordero (2nd Supervisor)
Dr Nora Andriopoulou (3rd Supervisor)