Visual feedback in written imaginal exposure for posttraumatic stress: a preliminary study

This study investigated the visual feedback hypothesis, which states that visual feedback from written trauma narratives contributes to the efficacy of written imaginal exposure for posttraumatic stress via the reuptake of traumatic content during production of the narrative. We tested a college sample (n = 61) with clinically elevated posttraumatic stress as measured with the Impact of Events Scale. Participants were randomly assigned to a writing with visual feedback condition, a writing without visual feedback condition, or a control condition. The hypothesis was not supported: Writing with and without visual feedback equally reduced intrusion and avoidance symptoms. Exploratory analyses, however, showed increased intrusion symptoms immediately after writing with visual feedback, which was in contrast with decreased symptom levels in the other conditions. These findings are in line with previous findings regarding immediate symptom development following writing interventions for posttraumatic stress and call for further exploration of the visual feedback hypothesis.