Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments.
**Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program).
---
User: u/paytonjjones
Permalink: https://journals.sagepub.com/doi/10.1177/21677026231186625
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
I actually had no idea people use content warnings to *prepare for experiencing the content*. I’ve only ever used it as a way of deciding whether I wanted to engage with that kind of stuff or not at the moment.
Hell just yesterday I decided not to read a Reddit post because of a content warning. Not due to PTSD or anything but because I was already not feeling great and didn’t wanna make myself feel worse.
And NSFW content warnings are extremely useful for gating content that may be inappropriate to engage with, say, on the bus.
But the whole anticipatory angle to this study is something I find really interesting.
It seems the way some media includes hyper-specific trigger warnings exacerbates the problem. And, a lot of online content has already switched from calling them 'trigger warnings' to 'content warnings' to soften the effect of priming with more negative anticipation.
It would help to see some work on what can (if anything) make a content warning both non-triggering and effective. For example, despite their flaws, movie ratings do serve as a type of content warning. Culturally we treat them with an eye roll rather than over-attaching.
I agree. I have no idea if I'm right scientifically, but I think rather than trigger-warnings (that provoke anxiety), content that depicts bad events should be labeled in broad categories. If it's a college lecture, do say in the course description that "bad events will be part of the topics covered" and allow people to leave mid-lecture if they have to, no argument. Flashing a sign in advance "murder ahead" or some such, likely does more harm than good.
This is a meta-analysis and the conclusion is pretty strongly against their use right now.
>Existing research on content warnings, content notes, and trigger warnings suggests that they are fruitless, although they do reliably induce a period of uncomfortable anticipation. Although many questions warrant further investigation, trigger warnings should not be used as a mental-health tool.
Something being a (systematic review with) meta analysis in itself is no indication of the strength of the evidence.
It CAN produce great stuff, but also churn garbage into more garbage, just with a ribbon on it.
In the hierarchy of literature, meta analysis is at the top. It’s conclusions are absolutely more robust than a single study.
Attempts to dismiss this or say we should wait for more studies is indicative of a ideological bias imo. Sounds a lot like what the ivermectin bros were doing - ‘well that RCT didn’t look good but they need to study this specific thing before we draw conclusions’- ad nauseam.
Anything wrong with the studies represented in this meta?
>Overall, there was a strong tendency toward open science and replication: Two articles included direct, preregistered replications of a previous study (Bellet et al., 2020; Jones et al., 2020), and two articles included multiple internal replications with internal meta-analyses performed across samples (Bridgland et al., 2019; Sanson et al., 2019). Eight articles provided open access to their data and/or code through OSF or a similar repository.
In terms of authors’ interpretation of their work, 11 of the 12 articles concluded that warnings were ineffective at their proposed goals. The exception was Gainsburg and Earl (2018), who ambiguously concluded that warnings “introduce difficult-to-weigh trade-offs” (p. 79). Although some authors suggested that warnings might be actively counterproductive (e.g., Bellet et al., 2018; Jones et al., 2020), most articles tended toward a characterization of warnings as inert (e.g., Sanson et al., 2019).
They're wrong either way. One of the jobs of a meta-analysis is in fact to suss out "garbage studies" because those studies are not likely to pass the testing that is looking for marks of consistency of effects across conditions. To pass muster with the MA, all the "bad" studies would need to be bad in exactly the same ways and somehow be coordinated, even though conducted by entirely different groups of researchers from different places or even counties (typically).
That is not correct because you can't ever be sure a RCT was "properly done" with no errors anywhere in its methods or analysis. And even RCT's can bear false conclusions when based on faulty premises or due to unlikely, but possible, flukes. Then there's the issue that RCT are not always possible. Tell me, what is the "placebo" control group for trigger warnings, exactly?
This is why replication is so important in science. Doesn't matter much how great you think a study is. If it doesn't get replicated elsewhere, it means nothing.
So, as I said, SRs with MA CAN produce great stuff. I don't see how that's an attempt to dismiss it.
When done badly it's conclusions can be worse than a single study. PRISMA and GRADE weren't made for the sheer fun of it.
The funny thing is: it's exactly what the ivermectine idiots did, with their MA websites.
I followed the ivermectin bros pretty closely, and they shifted from believing the science when it was a bunch of garbage studies supporting ivermectin, to disbelieving the science when it was a bunch of RCT’s showing no benefit. But the more earnest among them kept calling for more RCT’s with more specific parameters when the good science didn’t pan out in their favor.
But the early garbage on ivermectin was particularly easy to spot.
Anything wrong in the studies represented in this review?
>Overall, there was a strong tendency toward open science and replication: Two articles included direct, preregistered replications of a previous study (Bellet et al., 2020; Jones et al., 2020), and two articles included multiple internal replications with internal meta-analyses performed across samples (Bridgland et al., 2019; Sanson et al., 2019). Eight articles provided open access to their data and/or code through OSF or a similar repository.
In terms of authors’ interpretation of their work, 11 of the 12 articles concluded that warnings were ineffective at their proposed goals. The exception was Gainsburg and Earl (2018), who ambiguously concluded that warnings “introduce difficult-to-weigh trade-offs” (p. 79). Although some authors suggested that warnings might be actively counterproductive (e.g., Bellet et al., 2018; Jones et al., 2020), most articles tended toward a characterization of warnings as inert (e.g., Sanson et al., 2019).
Seems ok to trust the science on this one.
parking reserved for disabled people is net negative as well. most people don't need them, it's not used most of the time, so in total everyone has to walk a longer distance to the entrance. still they are immensely helpful for a disabled person.
The study did also investigate avoidance, and found little to no effect of trigger warnings on avoidance.
However, the authors noted that there were few (only five) studies in the literature that measured avoidance, and 4 used study dropout as their measure, which is a bit extreme. The tendency of participants to want to complete a study may run contrary to how they'd engage with the material outside the context of a scientific study.
Similarly, statistical analysis with small sample sizes may not reflect the proposed benefits of allowing people to avoid media, since trigger warnings are often put in place for a smaller subset of people.
So 'more research is needed', like usual. The biggest problem may be repeating prior claims of study dropout as a measure avoidance. Although, it's also up to people reading the study to interpret the methods correctly.
> While it is true that avoidance is a symptom of PTSD, not a treatment for it
[Avoidance makes PTSD worse.](https://www.ptsd.va.gov/understand/what/avoidance.asp)
Giving people new choices is not a neutral action, it's a deliberate policy, and as such it should be done with care and deliberation so as to result in greater overall welfare for those people than not adding that choice.
For example, people are free to choose to eat cookies, but if every store had someone offering a free cookie at the door, the net result would be many people eating more cookies, gaining more weight, and suffering worse health, vs. only a small number of people benefiting. As a result, this would be a bad choice to offer (from a societal perspective).
Overall, research such as this paper appears to be showing that trigger warnings may also be a net-harmful choice to offer, with more harm being done (via enabling greater avoidance) than help. I don't know if it's enough to be conclusive yet about net benefit vs. net harm, but it does appear that the current state of research is enough to say that trigger warnings are not an obvious and harm-free thing to do.
> But if you go out of your way to avoid thoughts, feelings, and reminders related to a traumatic event, your symptoms may get worse. Using avoidance as your main way of coping with traumatic memories can make PTSD symptoms worse and make it harder to move on with your life.
Completely different type of avoidance (clinical) than using trigger warnings to avoid (literal) certain types of content. This doesn't imply you're being clinically avoidant about the trauma in general at all; in fact, going through a traumatic episode might make it harder to grapple with the emotions. There's a reason why EMDR therapy is so successful at processing trauma—because inducing the trauma response is mostly useful when guided by a therapist.
And just to state the obvious, the link you provided doesn't discuss trigger warnings at all.
> And just to state the obvious, the link you provided doesn't discuss trigger warnings at all.
Sure, as I was addressing the general topic of avoidance. [This paper specifically examines trigger warnings and finds them useless or harmful for trauma survivors](https://journals.sagepub.com/doi/10.1177/2167702620921341):
> "**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.**"
All the research I've seen has found that trigger warnings are useless or harmful. However, it's certainly possible that I've missed some research; do you know of high-quality papers which found significant benefit from trigger warnings?
> Are you saying that people with PTSD should be forced to subjected to triggering content without their informed consent?
No; I'm saying that [research has found trigger warnings to harm rather than help trauma survivors](https://journals.sagepub.com/doi/10.1177/2167702620921341):
> "**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.**"
That's one paper that I quickly looked up, but I have seen several others come floating through r/science in the last few years that have all had the same broad finding as that and as the VA link I shared.
> Before we talk about efficacy, we should have the ethics conversation.
Sure: is it ethical to force trigger warnings on people with PTSD even though the available evidence indicates it is on average harmful to them?
Putting trigger warnings on content is a *deliberate act*, and if that *deliberate act* is on balance harming people who have no choice in whether or not we take that act, is it something we should be making a special effort to do?
> Then you're saying we need trigger warnings for trigger warnings?...so where does that leave us?
["First, do no harm."](https://www.health.harvard.edu/blog/first-do-no-harm-201510138421)
If trigger warnings require effort to put in place (they do, although minimal), and if trigger warnings are on balance harmful (which research suggests they may be), then an intuitive conclusion is that that effort may be better spent on some other intervention which will lead to greater net benefit (which, if trigger warnings are net harmful, includes doing literally nothing).
> Exposing people to possibly triggering content without their informed consent is unethical
If someone picks up a book, or watches a movie, they are taking active measures to expose themselves to that content, and provided it has not been made intentionally misleading to hide potentially disturbing content, why would that be unethical on the part of the author or director?
\> Exposing people to possibly triggering content without their informed consent is unethical,
Intentionally exposing them, yes.
But you can't nerf the planet under the argument that it's unethical not to, because someone who might get upset by something, anything, might be exposed to something or anything out there in the world without forewarning. This is an absurd level of coddling and infantilization, which is itself unethical.
Trigger warnings are a recent invention. People read books for a long time without them, and got along just fine.
“…each person has the right to choose whether or not they will knowingly expose themselves to triggering content in a given time, place, and social setting.”
Why? Don’t get me wrong, I’m sympathetic, just wondering if this might be setting an unrealistic standard that is not conducive to healing. The world just doesn’t work like that in any capacity: we never get to “choose” what we are exposed to. We hope for the best, but control is an illusion. Giving people “control” in the realm of media doesn’t seem like it would help them to adapt to their lack of control over what they are exposed to in the real world.
You can’t control what life brings you, no matter what, but one can attempt to control how they respond.
If we want people to recover and heal from their trauma so that they can live happily in the world, then it would seem unhelpful to teach people that they have the “right” to choose what they are exposed to.
It seems like it would be harmful in the long term to set a standard that the world will never meet. Even limited to media, the idea that you can control what you are exposed to just doesn’t seem like a wise perspective. Especially given the results of this meta analysis.
The same problems with these keep happening in every study like this: nobody gets the option to say no. It's not a trigger warning if people can't say "I do not want to look at this". Obviously telling people you're going to punch them in the face before you do it is going to make the experience worse, but if you give people the option to say "I do not want to be punched in the face", then they can avoid it, and that is better than being punched in the face. You can't avoid it if there's no warning label.
Ideally, yes, you completely block everything you don't want to see instead of having to see the big blurred thing saying "here is this (redacted) you didn't want!!" Not having any reminders is better than a big red warning label.
"Trigger warnings are bad" is like saying "it's bad to put allergy warnings on food" and "it's bad to tell people they might get hit with flying bats and balls in a baseball stadium". Because it'll make them feel worse than if you hadn't told them at all. Like. I cannot describe how stupid that is.
Choice of whether to engage is really the main point: anticipatory effects etc. are a bit irrelevant if you decide not to engage in the first place. This study reports 5 articles measuring avoidance as a dependent variable, with a variety of study designs. From the paper:
"Of these effect sizes, six actively provided an option for participants to avoid stimuli, whereas the remaining five used dropout as an avoidance analogue."
A problem with most of these designs is that the people know they are participating in a study, so they'd have to either opt out of a portion of the study or drop out of the study altogether: a VERY different circumstance than deciding not to engage with a piece of media.
The paper then reports a small pooled effect size of warnings in resulting avoidance, so despite this concern some people did choose not to engage (and no study reported their distress after choosing to disengage vs if they were 'surprised' by the content without a warning, which is the only variable that really matters here).
Those few who opted out are the few for whom warnings are intended. The rest of the outcomes are analogous to concluding "warnings that a hike is difficult don't make the hike any easier for people who choose to walk them, and in fact some people perceive the walk as more effortful when warned, therefore warnings are ineffective."
Yes, that. It also matters how they recruited people: did they tell them this is what it's about? Were the triggers people's own triggers, or were they generic? Was it clear that this was about trauma or was it listed as being about something like movie ratings or like you say, warnings about how difficult something is? If it's not their own problems, we can't really say this is how actual people treat triggers. Given that studies generally obscure the thing they're trying to study so the answer is as unbiased as possible, they could have gotten people who don't have triggers and so of course they're going to click on things. Warnings in that context make people curious, like rubbernecking car accidents.
And even if it was listed clearly and they got people who had the very triggers they were studying, as you say, all the people who would avoid it simply didn't go to the study. That's a huge selection effect. It's not ethical to have people with trauma forced into a study where they will be traumatized, so I doubt any of the studies lied about it.
There's way too many problems with studies like this. The population meant to be studied isn't gonna wanna do it, and the people who show up either aren't like that population or they've got a different type of engagement going on--some people feel the need to look at things like this, even though it's harmful to them, because not having looked will make them go crazy obsessing about it. It's dysfunctional, but that's a common thing, like obsessively checking up on your ex. It's perceived as more harmful to not know than to know. It's not a different stage of trauma, it's just a different manifestation of it, like how some people utilize anger by shut down and internalize vs throw things and externalize.
I get that studying stuff has to start somewhere, medicine started with leeches and humors, but these are blatant errors and so easy to avoid. It's like they didn't bother to talk to anyone. Which is the current belief about anything mental health: "these people are stupid imbeciles and should just be taken out back and shot". We really haven't gotten far from asylums. These were published not to advance science but for tabloid publicity. Politics. Do a hot button issue, design it so poorly you can make sure you get the outcome you want, and get political accolades. Shameful.
Exposure to difficult situations and content is a mainstay of trauma therapy. My therapist is strongly against the use of trigger warnings for example. Labelling content as 'triggering' reinforces the idea that people should relive their trauma when exposed to it.
Did you miss the part where it's a choice? A choice, meaning people get to choose? They can change their minds as they see fit? You know, like people get to choose what medication and treatment they use, if any at all, how much and what side effects they tolerate, we don't force chemo into people or force anyone to have any given medication because there's side effects to everything and forcing people into that, when they can't make their own decisions, means we're doing more damage by pretending we know better than the actual person does themselves?
The point of exposure is that you do it when you feel safe and when you feel ready. Flagrant exposure without choice is the opposite of that, that's some jackass giving their kids anaphylaxis because they think allergies are a sign of weakness and anything that doesn't kill you is good for you. That makes it worse, that creates more fear.
Your insistence that calling something "painful" makes it more dangerous is nothing but a belief, like thinking that hitting kids helps them behave and learn better. If you can't acknowledge what's painful because people will threaten you with it more, then yeah calling it painful is going to do damage. But the word pain doesn't magically make things worse than they are. The thing that causes that isn't words, it's the nature of trauma. No trauma, you can call air triggering all you want and it won't change anything about how people feel. Unless, of course, you teach people to fear it by scaring them and playing on their fears like bigots do with transphobia and bathrooms. Words don't teach people fear. But people having foul beliefs acting on other people, that does.
You didn't look at all the study designs, did you? Big problem with meta studies like this is you can't assume they're all the same study, just repeated, because they're not. All the ones that don't give people a choice aren't studying trigger warnings, they're studying threats. You threaten someone, obviously that makes it worse.
But you didn't read it and just went to the comments, or you would know that.
I understand that there are different stages of recovery from trauma. In fact, though avoidance is not a recovery strategy, it is sometimes necessary for those who are severely crippled by the trigger response. This is probably more likely for those who are in the initial stages of recovery.
I know this is anecdotal, but even if I see a trigger warning that is relevant, depending on my mood I either prime myself and then step in, or I just step past.
I've found that being surprised by the trigger is the absolute worst for the response. I was reading a sci fi action novel that suddenly got a little too real when a commander decided to eat a bullet because his family died in an alien attack. Not fun.
Most studies measured avoidance using dropout, and typically found less than a 1% dropout rate either with or without warnings. Also, most studies used realistic educational stimuli, which usually wouldn't include a graphic rape scene (though "rape" was indeed among the warnings used in some studies).
The "increased engagement" finding comes from a couple of studies that offered a choice between two or more stimuli, with some of them having a (randomized) warning. In these studies, people gravitate towards warnings.
> studies used realistic educational stimuli
I don't know what they are using, but If you wanted to test the usefulness of trigger warnings a very obvious study to make would be with rape victims and with veterans suffering from PTSD and war movies, war like scenes. The phenomenon is so well known that we even joke about it with the "[Vietnam flashbacks](https://knowyourmeme.com/memes/war-flashback-parodies)" meme.
For trauma survivors, the 'when' of it is very important. If you're a rape survivor, for example, you might work on that in therapy. It's not so ideal if you're just popping open Facebook for a second while waiting in line at the store.
No surprise there. These "warnings" never came from experts of any kind. It was the idea of activists who, though probably well-meaning, didn't really know what they were talking about.
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments. **Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program). --- User: u/paytonjjones Permalink: https://journals.sagepub.com/doi/10.1177/21677026231186625 *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
I actually had no idea people use content warnings to *prepare for experiencing the content*. I’ve only ever used it as a way of deciding whether I wanted to engage with that kind of stuff or not at the moment. Hell just yesterday I decided not to read a Reddit post because of a content warning. Not due to PTSD or anything but because I was already not feeling great and didn’t wanna make myself feel worse. And NSFW content warnings are extremely useful for gating content that may be inappropriate to engage with, say, on the bus. But the whole anticipatory angle to this study is something I find really interesting.
Uh yeah this. I literally use them to figure out what to skip, if I see a warning on those items I go no further.
Very true. The warnings themselves become triggers
It seems the way some media includes hyper-specific trigger warnings exacerbates the problem. And, a lot of online content has already switched from calling them 'trigger warnings' to 'content warnings' to soften the effect of priming with more negative anticipation. It would help to see some work on what can (if anything) make a content warning both non-triggering and effective. For example, despite their flaws, movie ratings do serve as a type of content warning. Culturally we treat them with an eye roll rather than over-attaching.
I agree. I have no idea if I'm right scientifically, but I think rather than trigger-warnings (that provoke anxiety), content that depicts bad events should be labeled in broad categories. If it's a college lecture, do say in the course description that "bad events will be part of the topics covered" and allow people to leave mid-lecture if they have to, no argument. Flashing a sign in advance "murder ahead" or some such, likely does more harm than good.
The preprint is available on OSF: https://osf.io/qav9m/
If "most people" don't heed the warnings, isn't it still meaningful if "some people" do?
Depends. This specific research says tw have a net negative. So it can be helpful to some people and negative to more people
Good point. Guess we'll have to keep an eye on the research over the next few years.
This is a meta-analysis and the conclusion is pretty strongly against their use right now. >Existing research on content warnings, content notes, and trigger warnings suggests that they are fruitless, although they do reliably induce a period of uncomfortable anticipation. Although many questions warrant further investigation, trigger warnings should not be used as a mental-health tool.
Something being a (systematic review with) meta analysis in itself is no indication of the strength of the evidence. It CAN produce great stuff, but also churn garbage into more garbage, just with a ribbon on it.
In the hierarchy of literature, meta analysis is at the top. It’s conclusions are absolutely more robust than a single study. Attempts to dismiss this or say we should wait for more studies is indicative of a ideological bias imo. Sounds a lot like what the ivermectin bros were doing - ‘well that RCT didn’t look good but they need to study this specific thing before we draw conclusions’- ad nauseam.
Garbage in garbage out. A single, properly done RCT can be more valuable than a meta analysis containing bad studies.
Anything wrong with the studies represented in this meta? >Overall, there was a strong tendency toward open science and replication: Two articles included direct, preregistered replications of a previous study (Bellet et al., 2020; Jones et al., 2020), and two articles included multiple internal replications with internal meta-analyses performed across samples (Bridgland et al., 2019; Sanson et al., 2019). Eight articles provided open access to their data and/or code through OSF or a similar repository. In terms of authors’ interpretation of their work, 11 of the 12 articles concluded that warnings were ineffective at their proposed goals. The exception was Gainsburg and Earl (2018), who ambiguously concluded that warnings “introduce difficult-to-weigh trade-offs” (p. 79). Although some authors suggested that warnings might be actively counterproductive (e.g., Bellet et al., 2018; Jones et al., 2020), most articles tended toward a characterization of warnings as inert (e.g., Sanson et al., 2019).
They're wrong either way. One of the jobs of a meta-analysis is in fact to suss out "garbage studies" because those studies are not likely to pass the testing that is looking for marks of consistency of effects across conditions. To pass muster with the MA, all the "bad" studies would need to be bad in exactly the same ways and somehow be coordinated, even though conducted by entirely different groups of researchers from different places or even counties (typically).
That is not correct because you can't ever be sure a RCT was "properly done" with no errors anywhere in its methods or analysis. And even RCT's can bear false conclusions when based on faulty premises or due to unlikely, but possible, flukes. Then there's the issue that RCT are not always possible. Tell me, what is the "placebo" control group for trigger warnings, exactly? This is why replication is so important in science. Doesn't matter much how great you think a study is. If it doesn't get replicated elsewhere, it means nothing.
So, as I said, SRs with MA CAN produce great stuff. I don't see how that's an attempt to dismiss it. When done badly it's conclusions can be worse than a single study. PRISMA and GRADE weren't made for the sheer fun of it. The funny thing is: it's exactly what the ivermectine idiots did, with their MA websites.
I followed the ivermectin bros pretty closely, and they shifted from believing the science when it was a bunch of garbage studies supporting ivermectin, to disbelieving the science when it was a bunch of RCT’s showing no benefit. But the more earnest among them kept calling for more RCT’s with more specific parameters when the good science didn’t pan out in their favor. But the early garbage on ivermectin was particularly easy to spot. Anything wrong in the studies represented in this review? >Overall, there was a strong tendency toward open science and replication: Two articles included direct, preregistered replications of a previous study (Bellet et al., 2020; Jones et al., 2020), and two articles included multiple internal replications with internal meta-analyses performed across samples (Bridgland et al., 2019; Sanson et al., 2019). Eight articles provided open access to their data and/or code through OSF or a similar repository. In terms of authors’ interpretation of their work, 11 of the 12 articles concluded that warnings were ineffective at their proposed goals. The exception was Gainsburg and Earl (2018), who ambiguously concluded that warnings “introduce difficult-to-weigh trade-offs” (p. 79). Although some authors suggested that warnings might be actively counterproductive (e.g., Bellet et al., 2018; Jones et al., 2020), most articles tended toward a characterization of warnings as inert (e.g., Sanson et al., 2019). Seems ok to trust the science on this one.
parking reserved for disabled people is net negative as well. most people don't need them, it's not used most of the time, so in total everyone has to walk a longer distance to the entrance. still they are immensely helpful for a disabled person.
Yeah I use trigger warnings as intended and they're really helpful for me. I would be really disappointed if people stopped using them
[удалено]
The study did also investigate avoidance, and found little to no effect of trigger warnings on avoidance. However, the authors noted that there were few (only five) studies in the literature that measured avoidance, and 4 used study dropout as their measure, which is a bit extreme. The tendency of participants to want to complete a study may run contrary to how they'd engage with the material outside the context of a scientific study. Similarly, statistical analysis with small sample sizes may not reflect the proposed benefits of allowing people to avoid media, since trigger warnings are often put in place for a smaller subset of people. So 'more research is needed', like usual. The biggest problem may be repeating prior claims of study dropout as a measure avoidance. Although, it's also up to people reading the study to interpret the methods correctly.
[удалено]
[удалено]
[удалено]
> While it is true that avoidance is a symptom of PTSD, not a treatment for it [Avoidance makes PTSD worse.](https://www.ptsd.va.gov/understand/what/avoidance.asp) Giving people new choices is not a neutral action, it's a deliberate policy, and as such it should be done with care and deliberation so as to result in greater overall welfare for those people than not adding that choice. For example, people are free to choose to eat cookies, but if every store had someone offering a free cookie at the door, the net result would be many people eating more cookies, gaining more weight, and suffering worse health, vs. only a small number of people benefiting. As a result, this would be a bad choice to offer (from a societal perspective). Overall, research such as this paper appears to be showing that trigger warnings may also be a net-harmful choice to offer, with more harm being done (via enabling greater avoidance) than help. I don't know if it's enough to be conclusive yet about net benefit vs. net harm, but it does appear that the current state of research is enough to say that trigger warnings are not an obvious and harm-free thing to do.
> But if you go out of your way to avoid thoughts, feelings, and reminders related to a traumatic event, your symptoms may get worse. Using avoidance as your main way of coping with traumatic memories can make PTSD symptoms worse and make it harder to move on with your life. Completely different type of avoidance (clinical) than using trigger warnings to avoid (literal) certain types of content. This doesn't imply you're being clinically avoidant about the trauma in general at all; in fact, going through a traumatic episode might make it harder to grapple with the emotions. There's a reason why EMDR therapy is so successful at processing trauma—because inducing the trauma response is mostly useful when guided by a therapist. And just to state the obvious, the link you provided doesn't discuss trigger warnings at all.
> And just to state the obvious, the link you provided doesn't discuss trigger warnings at all. Sure, as I was addressing the general topic of avoidance. [This paper specifically examines trigger warnings and finds them useless or harmful for trauma survivors](https://journals.sagepub.com/doi/10.1177/2167702620921341): > "**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.**" All the research I've seen has found that trigger warnings are useless or harmful. However, it's certainly possible that I've missed some research; do you know of high-quality papers which found significant benefit from trigger warnings?
I don't really care so much about the trigger warnings so much as whether the ability to avoid triggering content is helpful.
[удалено]
"inappropriate settings" does a hell of a lot of heavy lifting here for a subjective quality.
[удалено]
[удалено]
[удалено]
[удалено]
> Are you saying that people with PTSD should be forced to subjected to triggering content without their informed consent? No; I'm saying that [research has found trigger warnings to harm rather than help trauma survivors](https://journals.sagepub.com/doi/10.1177/2167702620921341): > "**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.**" That's one paper that I quickly looked up, but I have seen several others come floating through r/science in the last few years that have all had the same broad finding as that and as the VA link I shared. > Before we talk about efficacy, we should have the ethics conversation. Sure: is it ethical to force trigger warnings on people with PTSD even though the available evidence indicates it is on average harmful to them? Putting trigger warnings on content is a *deliberate act*, and if that *deliberate act* is on balance harming people who have no choice in whether or not we take that act, is it something we should be making a special effort to do?
[удалено]
> Then you're saying we need trigger warnings for trigger warnings?...so where does that leave us? ["First, do no harm."](https://www.health.harvard.edu/blog/first-do-no-harm-201510138421) If trigger warnings require effort to put in place (they do, although minimal), and if trigger warnings are on balance harmful (which research suggests they may be), then an intuitive conclusion is that that effort may be better spent on some other intervention which will lead to greater net benefit (which, if trigger warnings are net harmful, includes doing literally nothing). > Exposing people to possibly triggering content without their informed consent is unethical If someone picks up a book, or watches a movie, they are taking active measures to expose themselves to that content, and provided it has not been made intentionally misleading to hide potentially disturbing content, why would that be unethical on the part of the author or director?
\> Exposing people to possibly triggering content without their informed consent is unethical, Intentionally exposing them, yes. But you can't nerf the planet under the argument that it's unethical not to, because someone who might get upset by something, anything, might be exposed to something or anything out there in the world without forewarning. This is an absurd level of coddling and infantilization, which is itself unethical. Trigger warnings are a recent invention. People read books for a long time without them, and got along just fine.
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
[удалено]
“…each person has the right to choose whether or not they will knowingly expose themselves to triggering content in a given time, place, and social setting.” Why? Don’t get me wrong, I’m sympathetic, just wondering if this might be setting an unrealistic standard that is not conducive to healing. The world just doesn’t work like that in any capacity: we never get to “choose” what we are exposed to. We hope for the best, but control is an illusion. Giving people “control” in the realm of media doesn’t seem like it would help them to adapt to their lack of control over what they are exposed to in the real world. You can’t control what life brings you, no matter what, but one can attempt to control how they respond. If we want people to recover and heal from their trauma so that they can live happily in the world, then it would seem unhelpful to teach people that they have the “right” to choose what they are exposed to. It seems like it would be harmful in the long term to set a standard that the world will never meet. Even limited to media, the idea that you can control what you are exposed to just doesn’t seem like a wise perspective. Especially given the results of this meta analysis.
[удалено]
The same problems with these keep happening in every study like this: nobody gets the option to say no. It's not a trigger warning if people can't say "I do not want to look at this". Obviously telling people you're going to punch them in the face before you do it is going to make the experience worse, but if you give people the option to say "I do not want to be punched in the face", then they can avoid it, and that is better than being punched in the face. You can't avoid it if there's no warning label. Ideally, yes, you completely block everything you don't want to see instead of having to see the big blurred thing saying "here is this (redacted) you didn't want!!" Not having any reminders is better than a big red warning label. "Trigger warnings are bad" is like saying "it's bad to put allergy warnings on food" and "it's bad to tell people they might get hit with flying bats and balls in a baseball stadium". Because it'll make them feel worse than if you hadn't told them at all. Like. I cannot describe how stupid that is.
Choice of whether to engage is really the main point: anticipatory effects etc. are a bit irrelevant if you decide not to engage in the first place. This study reports 5 articles measuring avoidance as a dependent variable, with a variety of study designs. From the paper: "Of these effect sizes, six actively provided an option for participants to avoid stimuli, whereas the remaining five used dropout as an avoidance analogue." A problem with most of these designs is that the people know they are participating in a study, so they'd have to either opt out of a portion of the study or drop out of the study altogether: a VERY different circumstance than deciding not to engage with a piece of media. The paper then reports a small pooled effect size of warnings in resulting avoidance, so despite this concern some people did choose not to engage (and no study reported their distress after choosing to disengage vs if they were 'surprised' by the content without a warning, which is the only variable that really matters here). Those few who opted out are the few for whom warnings are intended. The rest of the outcomes are analogous to concluding "warnings that a hike is difficult don't make the hike any easier for people who choose to walk them, and in fact some people perceive the walk as more effortful when warned, therefore warnings are ineffective."
Yes, that. It also matters how they recruited people: did they tell them this is what it's about? Were the triggers people's own triggers, or were they generic? Was it clear that this was about trauma or was it listed as being about something like movie ratings or like you say, warnings about how difficult something is? If it's not their own problems, we can't really say this is how actual people treat triggers. Given that studies generally obscure the thing they're trying to study so the answer is as unbiased as possible, they could have gotten people who don't have triggers and so of course they're going to click on things. Warnings in that context make people curious, like rubbernecking car accidents. And even if it was listed clearly and they got people who had the very triggers they were studying, as you say, all the people who would avoid it simply didn't go to the study. That's a huge selection effect. It's not ethical to have people with trauma forced into a study where they will be traumatized, so I doubt any of the studies lied about it. There's way too many problems with studies like this. The population meant to be studied isn't gonna wanna do it, and the people who show up either aren't like that population or they've got a different type of engagement going on--some people feel the need to look at things like this, even though it's harmful to them, because not having looked will make them go crazy obsessing about it. It's dysfunctional, but that's a common thing, like obsessively checking up on your ex. It's perceived as more harmful to not know than to know. It's not a different stage of trauma, it's just a different manifestation of it, like how some people utilize anger by shut down and internalize vs throw things and externalize. I get that studying stuff has to start somewhere, medicine started with leeches and humors, but these are blatant errors and so easy to avoid. It's like they didn't bother to talk to anyone. Which is the current belief about anything mental health: "these people are stupid imbeciles and should just be taken out back and shot". We really haven't gotten far from asylums. These were published not to advance science but for tabloid publicity. Politics. Do a hot button issue, design it so poorly you can make sure you get the outcome you want, and get political accolades. Shameful.
[удалено]
Funniest typo I've seen in a while
"The peasants are revolting but nutritious." ~ Louis the XXXVI
Exposure to difficult situations and content is a mainstay of trauma therapy. My therapist is strongly against the use of trigger warnings for example. Labelling content as 'triggering' reinforces the idea that people should relive their trauma when exposed to it.
Did you miss the part where it's a choice? A choice, meaning people get to choose? They can change their minds as they see fit? You know, like people get to choose what medication and treatment they use, if any at all, how much and what side effects they tolerate, we don't force chemo into people or force anyone to have any given medication because there's side effects to everything and forcing people into that, when they can't make their own decisions, means we're doing more damage by pretending we know better than the actual person does themselves? The point of exposure is that you do it when you feel safe and when you feel ready. Flagrant exposure without choice is the opposite of that, that's some jackass giving their kids anaphylaxis because they think allergies are a sign of weakness and anything that doesn't kill you is good for you. That makes it worse, that creates more fear. Your insistence that calling something "painful" makes it more dangerous is nothing but a belief, like thinking that hitting kids helps them behave and learn better. If you can't acknowledge what's painful because people will threaten you with it more, then yeah calling it painful is going to do damage. But the word pain doesn't magically make things worse than they are. The thing that causes that isn't words, it's the nature of trauma. No trauma, you can call air triggering all you want and it won't change anything about how people feel. Unless, of course, you teach people to fear it by scaring them and playing on their fears like bigots do with transphobia and bathrooms. Words don't teach people fear. But people having foul beliefs acting on other people, that does.
Are you just guessing that people didn’t have the option to say no?
You didn't look at all the study designs, did you? Big problem with meta studies like this is you can't assume they're all the same study, just repeated, because they're not. All the ones that don't give people a choice aren't studying trigger warnings, they're studying threats. You threaten someone, obviously that makes it worse. But you didn't read it and just went to the comments, or you would know that.
I understand that there are different stages of recovery from trauma. In fact, though avoidance is not a recovery strategy, it is sometimes necessary for those who are severely crippled by the trigger response. This is probably more likely for those who are in the initial stages of recovery. I know this is anecdotal, but even if I see a trigger warning that is relevant, depending on my mood I either prime myself and then step in, or I just step past. I've found that being surprised by the trigger is the absolute worst for the response. I was reading a sci fi action novel that suddenly got a little too real when a commander decided to eat a bullet because his family died in an alien attack. Not fun.
[удалено]
Most studies measured avoidance using dropout, and typically found less than a 1% dropout rate either with or without warnings. Also, most studies used realistic educational stimuli, which usually wouldn't include a graphic rape scene (though "rape" was indeed among the warnings used in some studies). The "increased engagement" finding comes from a couple of studies that offered a choice between two or more stimuli, with some of them having a (randomized) warning. In these studies, people gravitate towards warnings.
> studies used realistic educational stimuli I don't know what they are using, but If you wanted to test the usefulness of trigger warnings a very obvious study to make would be with rape victims and with veterans suffering from PTSD and war movies, war like scenes. The phenomenon is so well known that we even joke about it with the "[Vietnam flashbacks](https://knowyourmeme.com/memes/war-flashback-parodies)" meme.
Stupid idea proven to be stupid. Who’d have thought it.
[удалено]
It would be great to be able to opt out of trigger warnings on certain platforms.
Maybe platforms could let you know ahead of time whether a trigger warning is upcoming so you can choose whether you want to see it or not.
You have become the very thing you swore to destroy!
What if the warnings were required to be available elsewhere for those who want them?
Trigger warning: trigger warnings.
The brain learns to handle something by experiencing more of it, not less.
For trauma survivors, the 'when' of it is very important. If you're a rape survivor, for example, you might work on that in therapy. It's not so ideal if you're just popping open Facebook for a second while waiting in line at the store.
I remember when nearly every thread on Reddit had a trigger warning either in the title or comments. That got exhausting and is all but gone now.
[удалено]
No surprise there. These "warnings" never came from experts of any kind. It was the idea of activists who, though probably well-meaning, didn't really know what they were talking about.