Helping or Harming? The Effect of Trigger Warnings on Individuals With Trauma Histories

[rvallee]

Abstract

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.

I'm posting this mainly because of the interesting discussion on this Reddit thread:

It's an excellent look into the dynamics of the crisis of replicability that inflates meaningless editorialized results into seemingly credible clinical advice, along with very dubious methodological choices. The thread itself is filled with interesting discussion, one of which lead to the realization that this is a replication study by the same researchers of the study they are replicating. So they are replicating their own work, which is not how replication is supposed to work.

Interesting is discussion over the very specific, and particularly unnatural, wording in their own trigger warning, which lots of people pointed out is very artificial and unlike how it's normally used by people. This is the text of the warning:

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.

I have seen hundreds of organic uses of trigger/content warnings in the wild. None have ever looked like this. This is very unnatural wording, creating an artificial setting leading to an invalid experiment because of priming, given the natural imprecision in using questionnaires as outcomes. Specifically, the primary outcome is anxiety, which seems wholly inadequate and imprecise. I imagine other emotions would be in the mix, such as disgust and fear. Those are not anxiety and so would be missed entirely. Very thin-and-narrow choices to control the outcome.

Clinical psychology relies too much on artificial settings that simply have no counterpart in reality, similar to reducing the complex fluctuating illness in ME to just fatigue, and using a single alternate preferred meaning out of the many possible meanings this word can have. This is a similar problem that plagued things like Milgram's experiments, about which we now know the details are definitely not as they are generally portrayed, and the Stanford prison experiment, also debunked for having been largely artificial settings meant to prime an outcome.

It's probably not worth discussing much, I just found the discussion on the Reddit thread interesting. The crisis of replicability is clearly not treated with any seriousness in clinical psychology and the flaws are in no way limited to our own special hell with these people.

 

[Arnie Pye]

Your reddit link doesn't work for me as it stands, but it does if the excess / is removed from the end. I end up here when I do that :

https://www.reddit.com/r/science/comments/gyzrbt/trigger_warnings_are_ineffective_for_trauma/

I have seen hundreds of organic uses of trigger/content warnings in the wild. None have ever looked like this.

What does a "normal" trigger warning look like? I've seen a few but haven't paid any attention to them.

 

[Saz94]

Yeah what they did in that study isn't how trigger warnings are meant to work.

An example of what you'd usually see:

TW: rape

Thus, somebody who has a traumatic experience of rape has the opportunity to decide if it's not a good idea for them to read the thing at this time, or at all.

 

[James Morris-Lent]

I like that they wrote an abstract that contains no actual information.

It makes sense given the study data is a bunch of self-report questionnaires and 'slider bars'.

Don't they think it's bit rich to conclude that maybe an hour of reading with some trigger warnings 'countertherapeutically reinforce[d] survivors’ view of their trauma as central to their identity'?

It reminds me of the 'stereotype threat' idea that seems to have turned out to be nothing.

I don't personally see much point in trigger warnings in general. Of course if someone has PTSD we should accommodate them on an individual basis to the extent practical. On the other hand I don't see any reason why people should be stopped from using trigger warnings.


It's worth mentioning that on Reddit, for the most part, people just upvote whatever sounds good to them and then forget about it. Same as a cat photo. - r/science is pretty much headline clickbait.

 

[Trish]

I'm not a trauma survivor, so I'm not really relevant to the study, but surely trigger warnings are there to indicate the nature of the content of the article so people can, if they wish, respond by avoiding reading the article at all. That's how I respond to them.

It seems from the abstract that the people had to read the article anyway, so they overrode the trigger warning and defeated its purpose.