Intrusive memories following disaster: Relationship with peritraumatic responses and later affect.

Abstract

Cognitive theories of PTSD suggest that intrusive memories result from disrupted information processing during traumatic memory encoding and are characterized by fear, helplessness, and horror at recall. Existing naturalistic studies are limited by the absence of direct comparisons between specific moments that do and do not correspond to intrusive memories. We tested predictions from cognitive theories of PTSD by comparing peritraumatic responses during moments experienced as intrusive memories versus distressing moments of the same traumatic event from the same individual not experienced as intrusive memories. A further comparison was with highly distressing moments experienced during the same event by individuals without intrusive memories. We utilized a psychometrically generated model to distinguish different peritraumatic reactions. Moments experienced as intrusive memories were characterized by higher peritraumatic distress, immobility, cognitive overload, and somatic dissociation when compared both to distressing moments from the same individual that did not intrude, and to the most distressing memories of individuals without intrusions. Exploratory analyses indicated that at recall intrusive memories were characterized by higher levels of primary traumatic emotions such as anxiety, fear, and helplessness in comparison with non-intrusive memories. Findings from this novel naturalistic design support predictions made by cognitive theories of PTSD and have implications for research and preventative interventions targeting intrusive memories.

The memory and identity theory of ICD-11 complex posttraumatic stress disorder.

“…According to ICD-11, the defining feature of a traumatic event is that it is extremely threatening or horrific, and the reexperiencing symptoms are typically accompanied by fear or horror. This reflects the limited evidence to date suggesting that fear is the specific peritraumatic emotion most commonly associated with reexperiencing in PTSDs (Hellawell & Brewin, 2004;Massazza et al, 2021;Reynolds & Brewin, 1998). Fear is also the key emotion associated in the M&I theory with the downregulation of the visual ventral stream and the upregulation of the dorsal stream, leading to the intrusion of strong perceptual imagery with little associated context.…”

“…There is considerable evidence that reported alterations in the sense of self, in one's relation to reality, or in the passage of time, occurring during or after the traumatic event, are also associated with impairments in episodic memory for the event (Brewin, 2014). These dissociative reactions are commonly reported in PTSDs (Massazza et al, 2021;. Experimental evidence from a variety of sources indicates that there is a causal impact of these reactions on episodic memory (Bergouignan et al, 2014;Brewin & Mersaditabari, 2013), and that they lead to alterations in hippocampal activity (Bergouignan et al, 2014).…”

The International Trauma Questionnaire: An assessment of the psychometric properties of its Spanish version

“…Considering the emotions associated with the traumatic event in the sample, fear scored 29.79% followed by no emotions in 18.44% of cases: fear is common in PTSD and is part of diagnostic criteria [41] as well as is related to brain circuits of fear conditioning and extinction [42]. Intrusive memories may elicit intense fear responses in PTSD patients leading to intense stress with cognitive overload and somatic dissociation [43].…”