Trigger warnings alert trauma survivors about potentially disturbing forthcoming content. However, empirical studies on trigger warnings suggest that they are functionally inert or cause small adverse side effects. We conducted a preregistered replication and extension of a previous experiment. Trauma survivors ( N = 451) were randomly assigned to either receive or not to receive trigger warnings before reading passages from world literature. We found no evidence that trigger warnings were helpful for trauma survivors, for participants who self-reported a posttraumatic stress disorder (PTSD) diagnosis, or for participants who qualified for probable PTSD, even when survivors’ trauma matched the passages’ content. We found substantial evidence that trigger warnings countertherapeutically reinforce survivors’ view of their trauma as central to their identity. Regarding replication hypotheses, the evidence was either ambiguous or substantially favored the hypothesis that trigger warnings have no effect. In summary, we found that trigger warnings are not helpful for trauma survivors.
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clabs_man on June 8th, 2020 at 16:37 UTC »
I'm seeing a lot of "exposure is how you treat PTSD" comments in this thread. Surely the point is controlled exposure? A therapist leads someone through their trauma in a controlled manner, taking time to go through their feelings and notice their thought processes. The pace is managed, they probably take time to get upset in manageable pieces, reflect, and progress is gradually made.
The suggestion from some seems to be that any and all exposure is good for PTSD, perhaps because it "normalises" it. To me, without the pace and self-reflection of therapy, this seems to essentially add up to a "get used to it, bury your feelings by brute force" approach.
ForgetTheWords on June 8th, 2020 at 16:04 UTC »
In this study, the warning was in the form of text reading, "TRIGGER WARNING: The passage you are about to read contains disturbing content and may trigger an anxiety response, especially in those who have a history of trauma." It's easy to see how a warning like that could both prime a trauma survivor to experience anxiety and also cause them to think of themselves as "a person who has a history of trauma," thus increasing their score on something like the CES. Maybe what this study shows is that this particular style of trigger warning isn't very helpful, rather than that trigger warnings in general aren't helpful.
I, personally, prefer the term "content warning" rather than "trigger warning," partially for reasons herein discussed. You don't want to teach people that they are vulnerable and need to protect themselves from reminders of their trauma. But the term "content warning" is also useful because it makes clear that there are other reasons, besides trauma, that a person might want to know what kind of content a piece of media contains.
paytonjjones on June 8th, 2020 at 13:58 UTC »
The primary outcome in this particular study was the level of anxiety. Other studies have measured whether or not people who see trigger warnings use them to actually avoid material. These studies show somewhat conflicting results. However, if people do indeed avoid material based on trigger warnings, this is probably a bad thing. Avoidance is one of the core components of the CBT model of PTSD and exacerbates symptoms over time.
Seeing trauma as central to one's life, also known as "narrative centrality", is correlated with more severe levels of PTSD. It also mediates treatment outcomes, meaning that those who have decreases in narrative centrality in treatment tend to experience more complete recoveries.
Edit: Open-access postprint can be found here: https://osf.io/qajzy/