Intrusive memories as conditioned responses to trauma cues: An empirically supported concept?

Franke, Laila Katharina ; Rattel, Julina ; Miedl, Stephan Franz ; Danböck, Sarah K. ; Bürkner, Paul-Christian ; Wilhelm, Frank H.

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DOI:	https://doi.org/10.1016/j.brat.2021.103848
URL:	https://www.sciencedirect.com/science/article/pii/...
Additional URL:	https://www.researchgate.net/publication/350594547...
URN:	urn:nbn:de:bsz:180-madoc-652871
Document Type:	Article
Year of publication:	2021
The title of a journal, publication series:	Behaviour Research and Therapy
Volume:	143
Issue number:	Article 103848
Page range:	1-27
Place of publication:	Amsterdam [u.a.]
Publishing house:	Elsevier
ISSN:	0005-7967 , 1873-622X
Publication language:	English
Institution:	School of Social Sciences > Klinische u. Biologische Psychologie u. Psychotherapie (Alpers 2010-)
Pre-existing license:	Creative Commons Attribution 4.0 International (CC BY 4.0)
Subject:	150 Psychology 610 Medicine and health
Keywords (English):	posttraumatic stress disorder , pavlovian conditioning , exposure therapy , extinction , trauma film , imagery , intrusive memories
Abstract:	Intrusions in posttraumatic stress disorder (PTSD) are clinically understood as conditioned responses (CRs) to trauma-cues; however, experimental evidence for this is limited. We subjected 84 healthy participants to a differential conditioned-intrusion paradigm, where neutral faces served as conditioned stimuli (CSs) and aversive film clips as unconditioned stimuli (USs). While one group only completed acquisition, another group additionally received extinction. Subsequently, participants provided detailed e-diary intrusion reports. Several key findings emerged: First, participants in both groups re-experienced not only USs but also CSs as content of their intrusions. Second, intrusions were elicited by cues resembling CSs, USs, and experimental context. Third, extinction reduced probability and severity of US intrusions, and accelerated their decay, and this was particularly the case in participants showing greater cognitive (US-expectancy) and physiological (SCR) differential responding to CS+ vs. CS- at end of acquisition (i.e., conditionability). Similarly, extinction reduced CS-intrusion probability and severity, but only in participants with greater cognitive conditionability. These results support conditioning's role in re-experiencing in two critical ways: (1) Conditioning during trauma provides cues that not only function as reminder cues, but also as content of intrusions; (2) After strong conditioning, weakening the original CS-US relationship via extinction reduces intrusion formation after analogue-trauma.

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