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Kobelt M, Waldhauser GT, Rupietta A, Heinen R, Rau EMB, Kessler H, Axmacher N. The memory trace of an intrusive trauma-analog episode. Curr Biol 2024; 34:1657-1669.e5. [PMID: 38537637 DOI: 10.1016/j.cub.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/05/2023] [Accepted: 03/06/2024] [Indexed: 04/25/2024]
Abstract
Intrusive memories are a core symptom of posttraumatic stress disorder. Compared with memories of everyday events, they are characterized by several seemingly contradictory features: intrusive memories contain distinct sensory and emotional details of the traumatic event and can be triggered by various perceptually similar cues, but they are poorly integrated into conceptual memory. Here, we conduct exploratory whole-brain analyses to investigate the neural representations of trauma-analog experiences and how they are reactivated during memory intrusions. We show that trauma-analog movies induce excessive processing and generalized representations in sensory areas but decreased blood-oxygen-level-dependent (BOLD) responses and highly distinct representations in conceptual/semantic areas. Intrusive memories activate generalized representations in sensory areas and reactivate memory traces specific to trauma-analog events in the anterior cingulate cortex. These findings provide the first evidence of how traumatic events could distort memory representations in the human brain, which may form the basis for future confirmatory research on the neural representations of traumatic experiences.
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Affiliation(s)
- M Kobelt
- Department of Neuropsychology, Ruhr-Universität Bochum, Bochum 44801, North Rhine-Westphalia, Germany.
| | - G T Waldhauser
- Department of Neuropsychology, Ruhr-Universität Bochum, Bochum 44801, North Rhine-Westphalia, Germany.
| | - A Rupietta
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum 44787, North Rhine-Westphalia, Germany
| | - R Heinen
- Department of Neuropsychology, Ruhr-Universität Bochum, Bochum 44801, North Rhine-Westphalia, Germany
| | - E M B Rau
- Department of Neuropsychology, Ruhr-Universität Bochum, Bochum 44801, North Rhine-Westphalia, Germany
| | - H Kessler
- Department of Psychosomatic Medicine and Psychotherapy, Campus Fulda, Universität Marburg, Marburg 35032, Hessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-Universität Bochum, Bochum 44791, North Rhine-Westphalia, Germany
| | - N Axmacher
- Department of Neuropsychology, Ruhr-Universität Bochum, Bochum 44801, North Rhine-Westphalia, Germany.
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Neudert MK, Schäfer A, Zehtner RI, Fricke S, Seinsche RJ, Stark R, Hermann A. Decontextualized fear memories? Stronger conditioned fear responses during extinction learning and extinction recall in a safe context predict the development of long-term analog intrusions. Psychol Med 2024; 54:159-168. [PMID: 37129070 DOI: 10.1017/s0033291723001125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Difficulties in the context-dependent modulation of conditioned fear are known for posttraumatic stress disorder and may explain the occurrence of intrusive memories in safe contexts. The current study therefore investigated if reduced context-dependent modulation of conditioned fear and its underlying neural circuitry constitute risk factors for the development of analog intrusions in response to an experimental trauma. METHODS Eighty-five healthy women participated in the trauma film paradigm to investigate the development of analog intrusions as well as explicit memory for an experimental trauma after one week and three months, respectively. Before, participants underwent a context-dependent fear conditioning paradigm during functional magnetic resonance imaging with fear acquisition in context A and extinction training in context B on a first day, as well as extinction recall in context B and fear renewal in a novel context C one day later. Skin conductance responses (SCRs) and blood oxygen level dependent responses were main outcome measures. RESULTS In addition to stronger fear acquisition in context A, stronger conditioned fear responses in the safe context B, as indicated by stronger conditioned SCRs or stronger activation of fear expressing regions during extinction learning and recall, predicted the development of long-term analog intrusions. CONCLUSIONS Stronger fear responses in safe and danger contexts were risk factors for the development of long-term analog intrusions and point to decontextualized fear memories and difficulties in the context-dependent modulation of conditioned fear. Altered fear conditioning processes and reduced storage of contextual information may cause the occurrence of fear independent of context.
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Affiliation(s)
- Marie K Neudert
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Axel Schäfer
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Raphaela I Zehtner
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Susanne Fricke
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Rosa J Seinsche
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Andrea Hermann
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Giessen, Germany
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3
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Davidson P, Marcusson-Clavertz D. The effect of sleep on intrusive memories in daily life: a systematic review and meta-analysis of trauma film experiments. Sleep 2023; 46:6844013. [PMID: 36420573 PMCID: PMC9905779 DOI: 10.1093/sleep/zsac280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
STUDY OBJECTIVES To synthesize the literature on the effect of sleep versus wake on the frequency and distress of intrusive memories in everyday life after watching film clips with distressing content as a proxy for traumatic experiences. METHODS We conducted a systematic review by searching PubMed and PsychInfo. The last search was conducted on January 31, 2022. We included experimental studies comparing sleep and wake groups on intrusions using ecological diary methods, whereas studies lacking a wake control condition or relying solely on intrusion-triggering tasks or retrospective questionnaires were excluded. Meta-analyses were performed to evaluate the results. Risks of biases were assessed following the Cochrane guidelines. RESULTS Across 7 effect sizes from 6 independent studies, sleep (n = 192), as compared to wake (n = 175), significantly reduced the number of intrusive memories (Hedges' g = -0.26, p = .04, 95% CI [-0.50, -0.01]), but not the distress associated with them (Hedges' g = -0.14, p = .25, 95% CI [-0.38, 0.10]). CONCLUSIONS Although the results suggest that sleep reduces the number of intrusions, there is a strong need for high-powered pre-registered studies to confirm this effect. Risks of biases in the reviewed work concern the selection of the reported results, measurement of the outcome, and failure to adhere to the intervention. Limitations with the current meta-analysis include the small number of studies, which comprised only English-language articles, and the fact that it was not pre-registered.
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Affiliation(s)
- Per Davidson
- Department of Psychology, Lund University, Lund, Sweden.,Department of Psychiatry, Massachusetts General Hospital, MA, USA.,Department of Psychiatry, Harvard Medical School, MA, USA
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Shi Z. Commentary: Virtual Reality, Real Emotions: A Novel Analogue for the Assessment of Risk Factors of Post-traumatic Stress Disorder. Front Psychol 2022; 13:936930. [PMID: 35756289 PMCID: PMC9218340 DOI: 10.3389/fpsyg.2022.936930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Zhongyu Shi
- College of Creative Culture and Communication, Zhejiang Normal University, Jinhua, China
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Gvozdanovic G, Stämpfli P, Seifritz E, Rasch B. Structural brain differences predict early traumatic memory processing. Psychophysiology 2019; 57:e13354. [PMID: 30825218 DOI: 10.1111/psyp.13354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 12/21/2018] [Accepted: 01/20/2019] [Indexed: 01/31/2023]
Abstract
Intrusive memories are a key symptom of post-traumatic stress disorder (PTSD). They emerge early after trauma exposure and are predictive for PTSD development. There is a high relevance in evaluating the neurobiological mechanisms of early stages of intrusive symptom development to provide a further understanding of PTSD. In the present study, we explore structural differences in healthy young female subjects preceding experimental trauma exposure and their relationship to early intrusive memory development using a traumatic film paradigm. With voxel-based morphometry, we demonstrate that smaller insular volume was associated with an increased number of early intrusive film memories. Moreover, larger lingual gyrus/cerebellar and inferior frontal gyrus/precentral gyrus volumes were also related to an increased number of early intrusive film memories. Our results identify unique brain areas associated with early experimental trauma memory processing and highlight the necessity of evaluating early symptom stages relevant for personalized PTSD prevention and treatment.
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Affiliation(s)
- Geraldine Gvozdanovic
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland.,Institute of Psychology, University of Zürich, Zürich, Switzerland
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland.,MR-Center of the Department of Psychiatry, Psychotherapy and Psychosomatics and the Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Zürich, Zürich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland.,Competence Center of Sleep & Health Zürich, University of Zürich, Zürich, Switzerland
| | - Björn Rasch
- Competence Center of Sleep & Health Zürich, University of Zürich, Zürich, Switzerland.,Department of Psychology, University of Fribourg, Fribourg, Switzerland
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6
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Woud ML, Heeren A, Shkreli L, Meyer T, Egeri L, Cwik JC, Zlomuzica A, Kessler H, Margraf J. Investigating the effect of proactive interference control training on intrusive memories. Eur J Psychotraumatol 2019; 10:1611092. [PMID: 31143413 PMCID: PMC6522906 DOI: 10.1080/20008198.2019.1611092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/10/2019] [Accepted: 04/10/2019] [Indexed: 11/30/2022] Open
Abstract
Intrusive re-experiencing is a hallmark symptom of Posttraumatic Stress Disorder (PTSD). According to prominent models of intrusive phenomena, intrusive memories may result from impairments in the efficiency of working memory capacity (WMC), more specifically proactive interference control. Yet, experimental research is scarce. Therefore, the present study aimed to investigate experimentally the role of proactive interference control in intrusive memories. We randomly assigned 57 healthy participants to either receive a high interference control training or a low interference control training. Participants were then exposed to highly distressing film clips. WMC was assessed before and after the training. Intrusion symptoms were assessed directly post-training and after one week using an Intrusion Provocation Task (IPT), a one-week intrusions diary, and the retrospective intrusion subscale of the Impact of Event Sale - Revised (IES-R). Results indicated that both groups reported improvements in WMC and fewer intrusions on the second IPT post-training, with no differences between groups. Similarly, no group differences on intrusions were found at one-week follow-up (i.e., intrusion diary and IES-R). To conclude, these data are not consistent with the hypothesis that WMC plays a role in intrusive re-experiencing. Implications for future research are discussed.
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Affiliation(s)
- Marcella L Woud
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Alexandre Heeren
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Clinical Neuroscience Division, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Lorika Shkreli
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas Meyer
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Institute of Psychology, University of Münster, Münster, Germany
| | - Leonie Egeri
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Jan C Cwik
- Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, University of Cologne, Köln, Germany
| | - Armin Zlomuzica
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
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Abstract
Vantage perspective during recall is thought to affect the emotionality and accessibility of distressing memories. This study aimed to test the effects of vantage perspective during recall on memory associated distress and intrusion development. An adapted version of the trauma film paradigm was used in an experimental design with three conditions. Participants were asked to listen to eyewitness reports of car accidents (e.g. Trauma Analogue Induction) and imagine the scenes vividly using mental imagery. Afterwards, they were asked to recall the most distressing scene from field perspective, observer perspective, or to recall a neutral image from observer perspective (control condition) (e.g. Trauma Analogue Recall). Recall from field perspective resulted in higher negative mood, state-anxiety, and a higher number of short-term intrusions compared to the observer perspective condition and control condition. Negative mood and state-anxiety were mediators in the relationship between vantage perspective and intrusions. In comparison to observer perspective, field perspective increased the amount of short-term intrusions as a result of higher levels of negative mood and state-anxiety after memory retrieval. Future research on the interaction between vantage perspective at recall and negative mood and anxiety effects is warranted.
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Affiliation(s)
- Nora Mooren
- a Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , the Netherlands
| | - Julie Krans
- a Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , the Netherlands.,b Pro Persona Research , Overwaal Centre for Anxiety, OCD, and PTSD , Nijmegen , the Netherlands
| | - Gérard Näring
- a Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , the Netherlands
| | - Agnes van Minnen
- a Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , the Netherlands.,b Pro Persona Research , Overwaal Centre for Anxiety, OCD, and PTSD , Nijmegen , the Netherlands
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Lass-Hennemann J, Schäfer SK, Römer S, Holz E, Streb M, Michael T. Therapy Dogs as a Crisis Intervention After Traumatic Events? - An Experimental Study. Front Psychol 2018; 9:1627. [PMID: 30233464 PMCID: PMC6132135 DOI: 10.3389/fpsyg.2018.01627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 08/14/2018] [Indexed: 11/15/2022] Open
Abstract
Animal-assisted therapy has been proposed as a treatment adjunct for traumatized patients. In animal-assisted crisis response, dogs are used directly after a traumatic event to reduce stress and anxiety. However, to date there are few controlled studies investigating the effects of therapy dogs on PTSD symptoms and to our knowledge there is no study investigating the effects of a therapy dog intervention directly after a traumatic event. In this study, 60 healthy female participants were randomly assigned to one of three groups: after exposure to a “traumatic” film clip (trauma-film paradigm), one group of participants interacted with a friendly dog for 15 min, another group of participants watched a film clip showing a person interacting with a friendly dog and the last group was instructed to relax. Participants who had interacted with the dog after the film reported lower anxiety levels, less negative affect, and more positive affect after the intervention as compared to the other two groups. However, the participants who interacted with the dog showed a smaller decrease in physiological arousal after the traumatic film clip compared to both other groups. There were no differences in intrusion symptoms between the three groups. Our results show that dogs are able to lessen subjectively experienced stress and anxiety after a “traumatic” stress situation.
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Affiliation(s)
- Johanna Lass-Hennemann
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Sarah K Schäfer
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Sonja Römer
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Elena Holz
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Markus Streb
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
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Seebauer LE, Naumann E, Jacobs A, Thier M, Jacob GA. Is It Possible to Enhance Intensity in Guided Imagery Exercises? An Experimental Study. J Cogn Psychother 2018; 32:38-48. [PMID: 32746412 DOI: 10.1891/0889-8391.32.1.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Guided imagery exercises can have a powerful impact on distressing mental images. Clinically, it is usually recommended to experience these exercises as intensely as possible. However, patients sometimes object to the related instructions. In this study, we tested whether typical clinical instructions aiming at increasing intensity led to a stronger effect of the exercise. METHODS Sixty-four healthy participants watched a trauma movie clip. Then they were pseudo-randomized into one of two strategies (intense, less intense) or a waiting control condition. Dependent variables were self-reported emotional intensity and psychophysiology measures. RESULTS Participants in the intense ImRS strategy did not experience the exercise as more intense than those in the less intense ImRS strategy on any outcome measure. Both ImRS strategies showed increased sympathetic activation compared to a decrease of activation in the waiting control group. CONCLUSIONS Our results suggest that emotional intensity in guided imagery exercises may not depend very much on the therapist's instructions.
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Cuperus AA, Klaassen F, Hagenaars MA, Engelhard IM. A virtual reality paradigm as an analogue to real-life trauma: its effectiveness compared with the trauma film paradigm. Eur J Psychotraumatol 2017; 8:1338106. [PMID: 31139334 PMCID: PMC6516735 DOI: 10.1080/20008198.2017.1338106] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 05/25/2017] [Indexed: 01/15/2023] Open
Abstract
Background: The trauma film paradigm (TFP) is a well-established method to study the effects of analogue psychological trauma under controlled laboratory settings. It has been used to examine pre-, peri-, and post-trauma processes, and to create and test interventions. A possible drawback is that watching films is a somewhat passive endeavour that lacks active behavioural engagement. Virtual reality (VR) may provide a better alternative. Like the TFP, VR allows for experimental control. In addition, it can induce a greater 'feeling of presence' and allows interaction with the environment, enabling research on action-reaction associations. Objective: We aimed to validate the utility of a VR paradigm as an experimental model to study psychological trauma by comparing its effectiveness with the TFP. Method: One group of participants (N = 25) was shown an aversive film, and another group (N = 25) moved through a VR scene. Main outcome measures were intrusion frequency assessed with a 7-day diary and self-rated vividness and emotionality of recalled memories related to the film or VR scene. Results: The results indicate that the film and VR scene were equally effective in inducing vivid and intrusive memories. However, self-reported emotional intensity appeared to be higher for memories related to the film than for memories related to the VR scene. Conclusions: Perhaps the film was more effective in inducing emotional memories than the VR scene due to its more aversive content. However, the VR scene seemed equally effective in inducing vivid and intrusive memories, and merits further exploration in light of ethical considerations (less aversive content) and other presumably beneficial qualities (e.g. inducing a greater feeling of presence and allowing interaction with the environment).
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Affiliation(s)
- Anne A Cuperus
- Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands.,Triple, Alkmaar, The Netherlands
| | - Fayette Klaassen
- Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | | | - Iris M Engelhard
- Clinical Psychology, Utrecht University, Utrecht, The Netherlands
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Rombold F, Wingenfeld K, Renneberg B, Hellmann-Regen J, Otte C, Roepke S. Influence of the noradrenergic system on the formation of intrusive memories in women: an experimental approach with a trauma film paradigm. Psychol Med 2016; 46:2523-2534. [PMID: 27335220 DOI: 10.1017/s0033291716001379] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Intrusive memories of traumatic events are a core feature of post-traumatic stress disorder but little is known about the neurobiological formation of intrusions. The aim of this study was to determine whether the activity of the noradrenergic system during an intrusion-inducing stressor would influence subsequent intrusive memories. METHOD We conducted an experimental, double-blind, placebo-controlled study in 118 healthy women. Participants received a single dose of either 10 mg yohimbine, stimulating noradrenergic activity, or 0.15 mg clonidine, inhibiting noradrenergic activity, or placebo. Subsequently, they watched an established trauma film which induced intrusions. The number of consecutive intrusions resulting from the trauma film, the vividness of the intrusions, and the degree of distress evoked by the intrusions were assessed during the following 4 days. Salivary cortisol and α-amylase were collected before and after the trauma film. RESULTS A significant time × treatment interaction for the number of intrusions and the vividness of intrusions indicated a different time course of intrusions depending on treatment. Post-hoc tests revealed a delayed decrease of intrusions and a delayed decrease of intrusion vividness after the trauma film in the yohimbine group compared with the clonidine and placebo groups. Furthermore, after yohimbine administration, a significant increase in salivary cortisol levels was observed during the trauma film. CONCLUSIONS Our findings indicate that pharmacological activation of the noradrenergic system during an emotionally negative event makes an impact on consecutive intrusive memories and their vividness in healthy women. The noradrenergic system seems to be involved in the formation of intrusive memories.
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Affiliation(s)
- F Rombold
- Department of Psychiatry and Psychotherapy,Charité - Universitätsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany
| | - K Wingenfeld
- Department of Psychiatry and Psychotherapy,Charité - Universitätsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany
| | - B Renneberg
- Department of Psychology,Freie Universitaet Berlin,Berlin,Germany
| | - J Hellmann-Regen
- Department of Psychiatry and Psychotherapy,Charité - Universitätsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany
| | - C Otte
- Department of Psychiatry and Psychotherapy,Charité - Universitätsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany
| | - S Roepke
- Department of Psychiatry and Psychotherapy,Charité - Universitätsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany
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12
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Clark IA, Mackay CE. Mental Imagery and Post-Traumatic Stress Disorder: A Neuroimaging and Experimental Psychopathology Approach to Intrusive Memories of Trauma. Front Psychiatry 2015; 6:104. [PMID: 26257660 PMCID: PMC4510312 DOI: 10.3389/fpsyt.2015.00104] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 07/03/2015] [Indexed: 01/11/2023] Open
Abstract
This hypothesis and theory paper presents a pragmatic framework to help bridge the clinical presentation and neuroscience of intrusive memories following psychological trauma. Intrusive memories are a hallmark symptom of post-traumatic stress disorder (PTSD). However, key questions, including those involving etiology, remain. In particular, we know little about the brain mechanisms involved in why only some moments of the trauma return as intrusive memories while others do not. We first present an overview of the patient experience of intrusive memories and the neuroimaging studies that have investigated intrusive memories in PTSD patients. Next, one mechanism of how to model intrusive memories in the laboratory, the trauma film paradigm, is examined. In particular, we focus on studies combining the trauma film paradigm with neuroimaging. Stemming from the clinical presentation and our current understanding of the processes involved in intrusive memories, we propose a framework in which an intrusive memory comprises five component parts; autobiographical (trauma) memory, involuntary recall, negative emotions, attention hijacking, and mental imagery. Each component part is considered in turn, both behaviorally and from a brain imaging perspective. A mapping of these five components onto our understanding of the brain is described. Unanswered questions that exist in our understanding of intrusive memories are considered using the proposed framework. Overall, we suggest that mental imagery is key to bridging the experience, memory, and intrusive recollection of the traumatic event. Further, we suggest that by considering the brain mechanisms involved in the component parts of an intrusive memory, in particular mental imagery, we may be able to aid the development of a firmer bridge between patients' experiences of intrusive memories and the clinical neuroscience behind them.
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Affiliation(s)
- Ian A. Clark
- Department of Psychiatry, University of Oxford, Oxford, UK
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