Are trauma memories state-dependent? Intrusive memories following alcohol-involved sexual assault

Jaffe, Anna E.; Blayney, Jessica A.; Bedard‐Gilligan, Michele; Kaysen, Debra

doi:10.1080/20008198.2019.1634939

Cited by 10 publications

(9 citation statements)

References 47 publications

(60 reference statements)

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“…As such, longstanding cognition and behavior literature supports the idea that being awake and conscious during a traumatic event is not required for subsequent aversion and PTSD-like behavioral outcomes (e.g. drug-facilitated sexual assault, post-intensive care syndrome, and conditioned taste aversion to anesthetics (42)(43)(44)(45). Indeed, we take precautions to limit unnecessary re-exposure to potential blast-related cues (for example, we use different colored drapes and gowns on blast exposure days vs.…”

Section: Discussionmentioning

confidence: 97%

Repetitive Blast Promotes Chronic Aversion to Neutral Cues Encountered in the Peri-Blast Environment

Schindler

Terry

Wolden‐Hanson

et al. 2021

Journal of Neurotrauma

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Repetitive mild traumatic brain injury (mTBI) has been called the "signature injury" of military Servicemembers in the Iraq and Afghanistan wars and is highly comorbid with posttraumatic stress disorder (PTSD). Correct attribution of adverse blast-induced mTBI and/or PTSD remains challenging. Preclinical research using animal models can provide important insight into the mechanisms by which blast produces injury and dysfunction-but only to the degree by which such models reflect the human experience. Avoidance of trauma reminders is a hallmark of

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Section: Discussionmentioning

confidence: 97%

Repetitive Blast Promotes Chronic Aversion to Neutral Cues Encountered in the Peri-Blast Environment

Schindler

Terry

Wolden‐Hanson

et al. 2021

Journal of Neurotrauma

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“…The greater duration of treatment, in combination with the findings of a number of longitudinal studies, suggests that PTS arising from DFSA may be treatment refractory. Consistent findings indicate that DFSA may be associated with less severe acute stress symptomatology (Jaffe, Blayney, Bedard-Gilligan, & Kaysen, 2019 ; Jaffe, Hahn, & Gilmore, 2019 ) and shows a pattern of initially lower PTSD severity but a more chronic course of symptoms (Gong, Kamboj, & Curran, 2019 ). In their longitudinal study, Kaysen et al ( 2010 ) assessed PTSD symptom clusters in a community sample of 60 women at 2–5 weeks post-assault.…”

Section: Characteristics Of Drug-facilitated Sexual Assaultmentioning

confidence: 88%

“…Clearly, understanding how these occur has important clinical implications for treating DFSA as well as other trauma types in which memory is impaired. Re-experiencing symptoms in amnestic survivors may result from portions of trauma memory surfacing as intrusive recollections when triggered by a trauma-related stimulus (Jaffe et al, 2019 ; Jaffe et al, 2019 ). Survivors may re-experience disturbing emotional and physical sensations, which can occur without conscious memory of an event.…”

Section: Discussionmentioning

confidence: 99%

Drug-facilitated sexual assault, impaired trauma memory, and implications for mental health treatment

Fields

Young

Patel

et al. 2022

European Journal of Psychotraumatology

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Background Sexual assault (SA) is a highly prevalent global public health problem and a robust predictor of posttraumatic stress disorder (PTSD), substance use disorder (SUD), and suicidality. A large percentage are drug or alcohol facilitated (DFSA), impairing trauma memory and affecting the application of evidence-based treatments. Despite these problems, few have investigated DFSA-specific mental health (MH) needs. Objective Goals of this study were (1) to identify psychological sequelae characterizing DFSA towards explaining why symptoms have been treatment-refractory, comparing survivors with involuntary substance ingestion (forced, covert: DFSA-I), voluntary ingestion (DFSA-V), and non-DFSA; and (2) to determine how impaired trauma memory relates to the development of PTSD and depression symptoms. Method Data from a retrospective chart review of 74 adults receiving SA MH services at an outpatient trauma center are presented. The sample includes a 2-year cohort seen acutely at an urban rape treatment center. The study is one of the first to examine therapy records beyond case studies for DFSA. Logistic, Poisson, and negative binomial regression analyses of quantitative data and qualitative thematic analysis of trauma cognitions and treatment foci were conducted. Results DFSA-V had five times greater odds of SUD, and notable substance-related self-blame compared to DFSA-I. DFSA-I had prominent relationship distress and self-blame for missing danger of perpetrator drugging. Survivors with impaired trauma memory had significantly fewer hyper-arousal and overall PTSD symptoms, and specifically less hypervigilance. No differences were found in re-experiencing symptoms. Conclusion Impaired trauma memory is common in DFSA and is associated with fewer baseline hyper-arousal and overall PTS. Despite this, DFSA issues including re-experiencing symptoms that are particularly distressing without the ability to cognitively connect the intrusions contribute to increased treatment needs. Impaired memory limits the application of evidence-based treatments, and collectively these findings call for the development of trauma-specific treatment protocols to enhance recovery for DFSA survivors. HIGHLIGHTS Survivors of drug-facilitated sexual assault have prominent PTSD including reexperiencing, though trauma memory may not be encoded. • Those absent trauma memory have less hyperarousal, but DFSA complications explain why it is treatment refractory and inform treatment development.

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“…At the same time, IR survivors may be acutely aware that heavy drinking confers risk, and many indicated they were considering or actively trying to reduce their drinking. Alcohol use and drinking settings may also be a reminder of past IR (Jaffe et al, 2019), and related distress may also motivate IR survivors to reduce their drinking. Second, we considered responses to PNF.…”

Section: Discussionmentioning

confidence: 99%

Personalized normative feedback for hazardous drinking among college women: Differential outcomes by history of incapacitated rape.

Jaffe¹,

Blayney²,

Graupensperger³

et al. 2023

Psychology of Addictive Behaviors

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Objective: Personalized normative feedback (PNF) interventions are effective at reducing hazardous drinking in college. However, little is known about who is most receptive to PNF. College women with a history of alcohol-related incapacitated rape (IR) are at elevated risk for hazardous drinking, but it is unclear what impact intervention messaging may have on this group and how their outcomes compare to those without past IR. To address this gap, this study involved secondary data analysis of a large web-based clinical trial. Method: Heavy drinking college women (N = 1,188) were randomized into PNF (n = 895) or control conditions (n = 293). Postintervention, women reported their reactions to intervention messaging. Hazardous drinking outcomes (typical drinking, heavy episodic drinking [HED], peak estimated blood alcohol content [eBAC], blackout frequency) were assessed at baseline and 12 months. Results: Past IR was reported by 16.3% (n = 194) of women. Women with a history of IR reported more baseline hazardous drinking and greater readiness to change than women without IR. For those who received PNF, history of IR related to greater perceived impact of the intervention, but no difference in satisfaction with the message. After controlling for baseline drinking, regressions revealed the effect of PNF was moderated by IR for frequency of HED at 12 months. Simple main effects revealed PNF was associated with lower levels of hazardous drinking at follow-up among women with past IR. Conclusions: This initial investigation suggests PNF is a low resource and easily disseminated intervention that can have a positive impact on college women with past IR. Public Health Significance StatementA web-based personalized normative feedback intervention for alcohol use was compared to a control condition in college women. This preliminary study revealed the intervention was particularly effective for women with a history of incapacitated rape in leading to less frequent heavy episodic drinking 1 year later.

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Are trauma memories state-dependent? Intrusive memories following alcohol-involved sexual assault

Cited by 10 publications

References 47 publications

Repetitive Blast Promotes Chronic Aversion to Neutral Cues Encountered in the Peri-Blast Environment

Repetitive Blast Promotes Chronic Aversion to Neutral Cues Encountered in the Peri-Blast Environment

Drug-facilitated sexual assault, impaired trauma memory, and implications for mental health treatment

Personalized normative feedback for hazardous drinking among college women: Differential outcomes by history of incapacitated rape.

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