Is Trauma Memory Special? Trauma Narrative Fragmentation in PTSD: Effects of Treatment and Response

Clinical Psychological Science : a Journal of the Association for Psychological Science
Michele Bedard-GilliganNorah Feeny

Abstract

Seminal theories posit that fragmented trauma memories are critical to posttraumatic stress disorder (PTSD; van der Kolk & Fisler, 1995; Brewin, 2014) and that elaboration of the trauma narrative is necessary for recovery (e.g., Foa, Huppert, & Cahill, 2006). According to fragmentation theories, trauma narrative changes, particularly for those receiving trauma-focused treatment, should accompany symptom reduction. Trauma and control narratives in 77 men and women with chronic PTSD were examined pre- and post-treatment, comparing prolonged exposure (PE) and sertraline. Utilizing self-report, rater coding, and objective coding of narrative content, fragmentation was compared across narrative types (trauma, negative, positive) by treatment modality and response, controlling for potential confounds. Although sensory components increased with PE (d= 0.23 - 0.44), there were no consistent differences in fragmentation from pre- to post-treatment between PE and sertraline or treatment responders and non-responders. Contrary to theories, changes in fragmentation may not be a crucial mechanism underlying PTSD therapeutic recovery.

References

Mar 1, 1986·Hospital & Community Psychiatry·M J Horowitz
May 1, 1996·Computer Methods and Programs in Biomedicine·D Hedeker, R D Gibbons
Jan 1, 1994·Harvard Review of Psychiatry·B A van der Kolk
Feb 8, 1992·American Journal of Health Promotion : AJHP·M E Francis, J W Pennebaker
Apr 13, 2000·Behaviour Research and Therapy·A Ehlers, D M Clark
Apr 19, 2000·JAMA : the Journal of the American Medical Association·K BradyG M Farfel
Mar 31, 2001·Behaviour Research and Therapy·C R Brewin
Oct 3, 2001·Behaviour Research and Therapy·N Paunovic, L G Ost
Feb 16, 2002·Journal of Clinical Child and Adolescent Psychology : the Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53·James Jaccard, Vincent Guilamo-Ramos
Apr 2, 2002·The British Journal of Psychiatry : the Journal of Mental Science·James MurrayRichard A Mayou
Jun 12, 2002·Journal of Clinical Child and Adolescent Psychology : the Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53·James Jaccard, Vincent Guilamo-Ramos
Jul 3, 2002·Journal of Traumatic Stress·Agnes van MinnenKarin Roelofs
Dec 11, 2002·Journal of Behavior Therapy and Experimental Psychiatry·Sarah L HalliganAnke Ehlers
May 6, 2003·Clinical Psychology Review·Chris R Brewin, Emily A Holmes
Jun 11, 2003·Journal of Consulting and Clinical Psychology·Sarah L HalliganAnke Ehlers
Jul 3, 2004·Biological Psychiatry·Meena VythilingamJ Douglas Bremner
Jan 29, 2005·Annals of the New York Academy of Sciences·J Douglas Bremner, Eric Vermetten
Feb 11, 2005·Behaviour Research and Therapy·Anke EhlersMelanie Fennell
Feb 18, 2006·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Richard J McNally
Mar 28, 2006·Behaviour Research and Therapy·Charlie JonesChris R Brewin
May 23, 2006·Biological Psychiatry·Gregory J QuirkFrancisco González-Lima
Aug 8, 2006·Annals of the New York Academy of Sciences·J Douglas Bremner
Apr 7, 2007·Journal of Clinical Psychopharmacology·Letizia BossiniPaolo Castrogiovanni
May 2, 2007·Psychological Bulletin·Sally A Moore, Lori A Zoellner
Nov 17, 2007·Behaviour Research and Therapy·Michelle G CraskeAaron Baker
Nov 21, 2007·Journal of Abnormal Psychology·Richard A BryantRachel M Guthrie
Nov 27, 2007·Journal of Behavior Therapy and Experimental Psychiatry·Merel KindtMarieke Soeter
Apr 2, 2008·Journal of Consulting and Clinical Psychology·Birgit Kleim, Anke Ehlers
Feb 17, 2009·Depression and Anxiety·Marci J Regambal, Lynn E Alden
Apr 24, 2010·Consciousness and Cognition·David C Rubin
Dec 7, 2011·Journal of Traumatic Stress·Elisabeth S Mundorf, Sandra C Paivio
Jan 2, 2013·Journal of Consulting and Clinical Psychology·Birgit KleimAnke Ehlers
Jul 12, 2013·The Journal of Clinical Psychiatry·Bradley V WattsMatthew J Friedman
Nov 6, 2013·Journal of Consulting and Clinical Psychology·Alyson K ZaltaEdna B Foa
Nov 8, 2014·Psychological Trauma : Theory, Research, Practice and Policy·Jeff JaegerLori A Zoellner

❮ Previous
Next ❯

Citations

Jul 21, 2020·Anxiety, Stress, and Coping·Ateka A ContractorHeidemarie Blumenthal
Jan 14, 2021·Memory·Richard J McNally
Jan 28, 2021·International Journal of Environmental Research and Public Health·Cristina CivilottiDaniela Acquadro Maran

❮ Previous
Next ❯

Methods Mentioned

BETA
pharmacotherapist
pharmacotherapy

Software Mentioned

Linguistic Inquiry and Word Count ( LIWC )
SuperMix

Related Concepts

Related Feeds

Anxiety Disorders

Discover the latest research on anxiety disorders including agoraphobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder here.