Memory and Forgetting

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Abstract

Purpose of Review

I summarize recent developments in understanding the phenomenology of memory in PTSD, describe the most prominent theoretical models, and outline new forms of treatment aimed at modifying the traumatic memory.

Recent Findings

Intrusive memories that have the quality of being relived in the present have been highlighted in ICD-11. Debate over whether trauma memories are disorganized has led to a distinction between global narratives that are usually well rehearsed and episodic memories of the most frightening moments when disruptions and fragmentation may occur. Attempts to prevent the initial consolidation of trauma memories have promise in prevention but face practical difficulties. Theoretical developments have led to a number of promising treatments for established PTSD including pre-retrieval propranolol and imagery rescripting.

Summary

Research has suggested real possibilities to improve the prevention and treatment of PTSD by modifying trauma recall even though the theoretical basis for these interventions remains controversial.

Related collections

Most cited references 36

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The reactivation of a stored memory in the brain can make the memory transiently labile. During the time it takes for the memory to restabilize (reconsolidate) the memory can either be reduced by an amnesic agent or enhanced by memory enhancers. The change in memory expression is related to changes in the brain correlates of long-term memory. Many have suggested that such retrieval-induced plasticity is ideally placed to enable memories to be updated with new information. This hypothesis has been tested experimentally, with a translational perspective, by attempts to update maladaptive memories to reduce their problematic impact. We review here progress on reconsolidation updating studies, highlighting their translational exploitation and addressing recent challenges to the reconsolidation field.

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Anke Ehlers, Tanja Michael, Ann Hackmann (2004)

The article describes features of trauma memories in post-traumatic stress disorder (PTSD), including characteristics of unintentional re-experiencing symptoms and intentional recall of trauma narratives. Reexperiencing symptoms are usually sensory impressions and emotional responses from the trauma that appear to lack a time perspective and a context. The vast majority of intrusive memories can be interpreted as re-experiencing of warning signals, i.e., stimuli that signalled the onset of the trauma or of moments when the meaning of the event changed for the worse. Triggers of re-experiencing symptoms include stimuli that have perceptual similarity to cues accompanying the traumatic event. Intentional recall of the trauma in PTSD may be characterised by confusion about temporal order, and difficulty in accessing important details, both of which contribute to problematic appraisals. Recall tends to be disjointed. When patients with PTSD deliberately recall the worst moments of the trauma, they often do not access other relevant (usually subsequent) information that would correct impressions/predictions made at the time. A theoretical analysis of re-experiencing symptoms and their triggers is offered, and implications for treatment are discussed. These include the need to actively incorporate updating information ("I know now ...") into the worst moments of the trauma memory, and to train patients to discriminate between the stimuli that were present during the trauma ("then") and the innocuous triggers of re-experiencing symptoms ("now").

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Author and article information

Contributors

Chris R. Brewin: c.brewin@ucl.ac.uk

Journal

Journal ID (nlm-ta): Curr Psychiatry Rep

Journal ID (iso-abbrev): Curr Psychiatry Rep

Title: Current Psychiatry Reports

Publisher: Springer US (New York )

ISSN (Print): 1523-3812

ISSN (Electronic): 1535-1645

Publication date (Electronic): 28 August 2018

Publication date PMC-release: 28 August 2018

Publication date (Print): 2018

Volume: 20

Issue: 10

Electronic Location Identifier: 87

Affiliations

ISNI 0000000121901201, GRID grid.83440.3b, Clinical Educational & Health Psychology, , University College London, ; Gower Street, London, WC1E 6BT UK

Article

Publisher ID: 950

DOI: 10.1007/s11920-018-0950-7

PMC ID: 6132786

PubMed ID: 30155780

SO-VID: 8a3b0f74-f525-469c-bdd4-c19ae2f3e888

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.