An analogue study of intrusions

According to cognitive theorists, intrusive trauma memories have their origin in how information during the event is processed. Two studies investigated functional cognitive strategies during medical crises that might protect against intrusions. In Study 1, interviews with health-care professionals were used to identify cognitive strategies judged to be effective in controlling emotions and dealing with medical crises. Study 2 systematically manipulated the use of those strategies in a trauma analogue film paradigm. Experimental participants reported fewer intrusions, and less fear and avoidance of film-related stimuli during the subsequent week than controls. The manipulation did not affect anxiety during the film or memory disorganization. Implications for cognitive theories of intrusion development are discussed.     

Fewer intrusions after an attentional bias modification training for perceptual reminders of analogue trauma

The present experimental analogue study used computerised attention training to investigate the role of attention bias in the prediction of intrusive memories. After exposure to a trauma film, participants in a training group (n=22) were presented with a variant of the exogenic cueing task (ECT) in which visual film reminders (i.e., stills from the trauma film) were always presented during invalid and neutral control stimuli always during valid trials. The purpose of this cue-location contingency was reinforcing the direction of attention away from film reminders. Control participants (n=23) performed a similar training without such a contingency. Post-training processing bias was assessed with a single target Rapid Serial Visual Presentation (RSVP) task, in which trauma-film reminders served as task-irrelevant distracters appearing shortly before a neutral target. The frequency of film-related intrusions was recorded in a take-home diary and at a follow-up session three days after film viewing. Participants who underwent attention training reported fewer film-related intrusions and showed less interference by visual film distracters than controls. Implications for research on attention bias after real-life trauma are discussed.     

Fewer intrusions after an attentional bias modification training for perceptual reminders of analogue trauma

The present experimental analogue study used computerised attention training to investigate the role of attention bias in the prediction of intrusive memories. After exposure to a trauma film, participants in a training group (n=22) were presented with a variant of the exogenic cueing task (ECT) in which visual film reminders (i.e., stills from the trauma film) were always presented during invalid and neutral control stimuli always during valid trials. The purpose of this cue–location contingency was reinforcing the direction of attention away from film reminders. Control participants (n=23) performed a similar training without such a contingency. Post-training processing bias was assessed with a single target Rapid Serial Visual Presentation (RSVP) task, in which trauma-film reminders served as task-irrelevant distracters appearing shortly before a neutral target. The frequency of film-related intrusions was recorded in a take-home diary and at a follow-up session three days after film viewing. Participants who underwent attention training reported fewer film-related intrusions and showed less interference by visual film distracters than controls. Implications for research on attention bias after real-life trauma are discussed.     

The Influence of Thought Suppression and Cognitive Load on Intrusions and Memory Processes Following an Analogue Stressor

Ironic Process Theory and the role of thought suppression have been used in part to explain the phenomenon of intrusive memories in various disorders, including posttraumatic stress disorder. How thought suppression interacts with other cognitive processes believed to be instrumental in the development of traumatic intrusive memory is unclear. In an analogue study, thought suppression and cognitive processing was manipulated in 4 experimental groups after participants (n = 80) viewed a trauma film. The impact of suppression was examined in relation to self-reported intrusive experiences as well as via more objective methods (word stem and dot probe tasks) to assess potential preferential encoding of negative material. Cognitive load appeared to undermine thought suppression ability, with these participants experiencing more intrusions over the week relative to participants in all other conditions. This group also showed greater priming to negative film-related words, and both suppression groups demonstrated enhanced memory for film-related content on recognition testing. Thought suppression mediated the relationship between negative interpretations of initial intrusions and later intrusions experienced over the week. The findings are discussed in the context of ironic process theory and cognitive models of posttraumatic stress.     

老年人情景记忆更新的改变：竞争记忆的回溯性干扰

记忆更新是获取新知识的一种重要能力。大量研究显示老年人情景记忆受损,但鲜有研究探讨老年人情景记忆更新模式的改变。研究在匹配了老年人和年轻人编码程度的前提下,探讨情景记忆更新的老化效应及其潜在的认知机制。我们对AB-AC记忆更新范式进行了创新,同时考察了在项目改变和位置改变条件下的老化效应,并在测试阶段纳入诱饵选项,进一步排除编码程度带来的影响。研究结果显示年轻人能对A-B和A-C记忆分离存储,而老年人更多地受到回溯性记忆干扰,即在A-B测试中出现C的闯入,并且该干扰效应显著地大于诱饵刺激带来的影响。研究结果表明,在年轻人和老年人编码程度匹配的情况下,年轻人的记忆更新通过记忆分化来实现,而老年人更多地受到竞争记忆的回溯性干扰。     

Cognitive avoidance of intrusive memories: recall vantage perspective and associations with depression

Although recent research demonstrates that intrusive memories represent an overlapping cognitive feature of depression and post-traumatic stress disorder (PTSD), there is still a general paucity of research investigating the prevalence and maintenance of intrusive memories in depression. The current study investigated the association between a range of cognitive avoidant mechanisms that characterize PTSD samples (i.e., suppression, rumination, emotional detachment, and an observer vantage perspective) and intrusive memories of negative autobiographical events in relation to dysphoria. Hypotheses were based on the proposition that employment of these cognitive mechanisms would hinder the emotional processing of the negative event, thus contributing to the maintenance of intrusions. Results supported an association between negative intrusive memories, dysphoria, and avoidant mechanisms. Significant differences were also found between field and observer memories and measures of emotional detachment and rumination. Implications relating to intrusive memory maintenance and treatment approaches are discussed.     

Preferential processing of visual trauma-film reminders predicts subsequent intrusive memories

This study used an analogue design to test the hypothesis that preferential processing of visual trauma reminders in the aftermath of a stressful or traumatic event gives rise to subsequent intrusive memories. Shortly after the presentation of a stressful film fragment, participants (n=36) were asked to detect neutral targets (rotated buildings or nature scenes) in a single target rapid serial visual presentation (RSVP) paradigm. During half of the streams, the target was preceded by a distracter. The distracters consisted of visual images extracted from an earlier presented stressful film (e.g., persons and objects that figured in the film). The degree of interference by these film reminders predicted subsequent intrusions recorded in a one-week diary. The results provide evidence that a deficient ability to obtain attentional control over perceptual “trauma” reminders during goal-directed behaviour may set people at risk for persistent intrusive memories. Implications for research investigating attentional bias and intrusive memories in context of posttraumatic stress disorder (PTSD) are discussed.     

The effect of cognitive load and hyperarousal on negative intrusive memories

Clinical theories of post-traumatic stress suggest that encoding processes at the time of a trauma are critical in determining whether intrusive memories will develop. Potential mechanisms that might influence the development of intrusive memories were studied, as was objective memory performance. In an analogue design, 65 participants were randomised to three conditions (cognitive load, hyperventilation, and control), and then watched a film of traumatic content. Intrusive memories were recorded during the experimental phase and at 1-week follow-up. Support was found for the prediction that verbal cognitive load and hyperventilation would facilitate intrusion development immediately following exposure to the trauma film; however, this was not maintained at follow-up. Consistent with cognitive models of post-traumatic stress, thought suppression and the distress associated with intrusive experiences mediated the relationship between distress caused by the film and intrusions at 1-week follow-up. Objective memory testing indicated that the three experimental groups showed similar recall and recognition performance for the content of the film; however, relative to the control group, individuals in the cognitive load condition were significantly less able to place film scenes in the correct order.     

Does post-event cognitive load undermine thought suppression and increase intrusive memories after exposure to an analogue stressor?

Ironic process theory has been used in part to explain the phenomenon of intrusive memories in various disorders including post-traumatic stress disorder. How thought suppression interacts with other cognitive processes believed to be instrumental in the development of traumatic intrusive memory was tested. In an analogue design 120 participants were randomised to five conditions, four of which also required participants to attempt to suppress intrusive memories after viewing a film of traumatic content. Participants in three conditions were also required to perform concurrent tasks that acted as a cognitive load during suppression. Intrusive memories were recorded during the experimental phase and at 1-week follow-up. Contrary to predictions, post-film processing did not undermine suppression success. There was some suggestion that post-film processing resulted in those participants experiencing intrusions of shorter duration than the no-suppression control group in two 5-minute intrusion monitoring intervals at the initial and follow-up phase of the experiment, but this was not reflected in a 1-week diary measure of intrusions. All experimental groups performed in a similar fashion in terms of memory testing of the film's content. The findings are discussed in the context of ironic process theory and cognitive models of post-traumatic stress.     

Intrusive images and memories in major depression

Individuals with current major depression were interviewed to investigate the prevalence of distressing intrusive mental imagery among depressed patients and study the phenomenology of these intrusions. Of the 39 currently depressed patients, 17 experienced some form of repetitive intrusive imagery (i.e., either an intrusive memory or image), with intrusive memories being more common than images. The intrusive imagery was experienced as highly uncontrollable and interfered significantly with patients' everyday lives. The intrusions were experienced with a sense of 'nowness', as well as physical and emotional re-experiencing. Despite high levels of re-experiencing, levels of dissociation were very low. The intrusive imagery was in some patients part of a wider network of key defining autobiographical memories, consistent with the idea that it is likely to play a significant role in maintaining the patient's depressive mood. Interventions targeting these intrusions could potentially result in a positive shift in depressed mood.     

The nature of intrusive memories after trauma: the warning signal hypothesis

Individuals who had experienced a range of different traumas were asked to describe the quality and content of their intrusive memories. Visual intrusions were the most common, and thoughts were uncommon. Intrusion quality varied little with type of trauma. Intrusive memories commonly consisted of stimuli that were present immediately before the traumatic event happened or shortly before the moments that had the largest emotional impact (i.e., when the meaning of the event became more traumatic). It is suggested that intrusive memories are about stimuli that through temporal association with the trauma acquired the status of warning signals, i.e., stimuli that if encountered again would indicate impending danger. This explains why intrusive memories are accompanied by a sense of serious current threat. The warning signal hypothesis may be useful in guiding therapists in identifying the moments with the largest emotional impact that will need reprocessing in treatment, and in educating patients about the nature of reexperiencing symptoms.     

The use of safety behaviours to manage intrusive memories in depression

Cognitive models of clinical disorders conceptualise cognitive and behavioural safety-seeking behaviours as central to symptom persistence because they prevent disconfirmation of key maintaining beliefs. Despite growing evidence of the role of negative beliefs about intrusive memories in depression, it remains unclear why such beliefs persist. Accordingly, we examined whether safety behaviours in response to unhelpful beliefs about intrusive memories might play a role in their maintenance. Eighteen high dysphoric (i.e., BDI-II12) individuals who reported an intrusive negative autobiographical memory in the past week completed a battery of measures about their memory, associated negative beliefs and safety behaviours adopted in response to their beliefs. The most commonly endorsed beliefs reflected themes of wanting to control memories (e.g., ‘I should be able to rid my mind of this memory’) and self-deprecation about experiencing them (e.g., ‘Because I can’t control this memory, I am a weak person’). The beliefs prompted a range of safety behaviours, with cognitive distraction being the most common. The findings demonstrate that safety behaviours are common in response to maladaptive beliefs about intrusive memories. Treatment developments in this area are needed, and should incorporate strategies to challenge beliefs about memories, reduce the use of safety behaviours, and promote processing of intrusive memories.     

Trauma‐related rumination mediates the effect of naturally occurring depressive symptoms but not momentary low mood on trauma intrusions

Comorbid depression is known to contribute to the maintenance of posttraumatic stress disorder (PTSD) including distressing intrusive trauma memories. It is theorised that depression is a risk factor for persistent PTSD through preventing optimal habituation of distress provoked by trauma memories and reminders, but the underlying cognitive mechanisms responsible are uncertain. The present study investigated trauma‐related rumination as a possible mediator for the effect of depression on trauma intrusions. Participants received a low mood induction or control procedure. Following viewing an analogue trauma film, frequency of film‐related intrusions and associated distress levels were measured and at 1‐week follow‐up. Between the two occasions, participants rated their levels of rumination about the film. Existing depression symptoms but not induced momentary sad mood predicted frequency of film intrusions and associated distress at 1‐week follow‐up. Some evidence was found that ruminative trauma processing mediated the relationship between baseline depressive symptoms and later intrusion frequency and associated distress. Future research is warranted to better understand the role of rumination in the depression–intrusion relationship, which may shed light on the clinical applicability of rumination‐targeted intervention for PTSD and comorbid depression.     

Effects of proactive interference on non-verbal working memory

Working memory (WM) is a cognitive system responsible for actively maintaining and processing relevant information and is central to successful cognition. A process critical to WM is the resolution of proactive interference (PI), which involves suppressing memory intrusions from prior memories that are no longer relevant. Most studies that have examined resistance to PI in a process-pure fashion used verbal material. By contrast, studies using non-verbal material are scarce, and it remains unclear whether the effect of PI is domain-general or whether it applies solely to the verbal domain. The aim of the present study was to examine the effect of PI in visual WM using both objects with high and low nameability. Using a Directed-Forgetting paradigm, we varied discriminability between WM items on two dimensions, one verbal (high-nameability vs. low-nameability objects) and one perceptual (colored vs. gray objects). As in previous studies using verbal material, effects of PI were found with object stimuli, even after controlling for verbal labels being used (i.e., low-nameability condition). We also found that the addition of distinctive features (color, verbal label) increased performance in rejecting intrusion probes, most likely through an increase in discriminability between content–context bindings in WM.     

Reducing depressive intrusions via a computerized cognitive bias modification of appraisals task: Developing a cognitive vaccine

A feature of depression is the distressing experience of intrusive, negative memories. The maladaptive appraisals of such intrusions have been associated with symptom persistence. This study aimed to experimentally manipulate appraisals about depressive intrusions via a novel computerized cognitive bias modification (CBM) of appraisals paradigm, and to test the impact on depressive intrusion frequency for a standardized event (a depressive film). Forty-eight participants were randomly assigned to either a session of positive or negative CBM. Participants then watched a depressing film (including scenes of bereavement and bullying) and subsequently monitored the occurrence of depressive intrusions related to the film in a diary for one week. At one-week follow-up, participants completed additional measures of intrusions – the Impact of Event Scale (IES) and an intrusion provocation task. As predicted, compared to the negative condition, participants who underwent positive CBM showed a more positive appraisal bias. Further, one week later, positive CBM participants reported fewer intrusions of the film and had lower IES scores. Our findings demonstrate that it is possible to manipulate maladaptive appraisals about depressive intrusions via a computerized CBM task. Further, this effect transfers to reducing intrusive symptomatology related to a standardized event (a depressive film) over one week, suggesting novel clinical implications.     

The psychological processes underlying symptoms of thought interference in psychosis

Morrison and colleagues have proposed that auditory hallucinations are the result of cognitive intrusions being misattributed to an external source due to such thoughts being inconsistent with the person's beliefs about his or her own mental processes (metacognitive beliefs). The aim of this study was to investigate the applicability of this model to psychotic symptoms of thought interference. Fifty psychotic patients with and without thought interference were compared on (i) frequency of cognitive intrusions, (ii) metacognitive beliefs, (iii) source monitoring and (iv) appraisals of an unrelated anomalous event (a card trick). As predicted, individuals with thought interference had an increased frequency of cognitive intrusions and of maladaptive metacognitive appraisals, lower perceived cognitive control, and were more likely to endorse appraisals regarding 'permeability' of the mind, on the card trick task, in comparison to individuals without thought interference. No significant differences were found on any measure when the patient group was divided into hallucinators and non-hallucinators, once other variables were controlled for. These findings suggest that Morrison's model may be more parsimonious for symptoms of thought interference than for auditory hallucinations.     

The role of midfrontal theta oscillations across the development of cognitive control in preschoolers and school‐age children

The development of cognitive control enables children to better resist acting based on distracting information that interferes with the current action. Cognitive control improvement serves different functions that differ in part by the type of interference to resolve. Indeed, resisting to interference at the task‐set level or at the response‐preparation level is, respectively, associated with cognitive flexibility and inhibition. It is, however, unknown whether the same neural mechanism underlies these two functions across development. Studies in adults have revealed the contribution of midfrontal theta (MFT) oscillations in interference resolution. This study investigated whether MFT is involved in the resolution of different types of interference in two age groups identified as corresponding to different latent structures of executive functions. Preschool (4–6 years) and school children (6–8 years) were tested with a task involving interference at the response level and/or the task‐set level while (electroencephalogram) EEG was recorded. Behaviorally, response time and accuracy were affected by task‐set. Both age groups were less accurate when the interference occurred at the task‐set level and only the younger group showed decreased accuracy when interference was presented at the response‐preparation level. Furthermore, MFT power was increased, relative to the baseline, during the resolution of both types of interference and in both age groups. These findings suggest that MFT is involved in immature cognitive control (i.e., preschool and school‐ages), by orchestrating its different cognitive processes, irrespective of the interference to resolve and of the level of cognitive control development (i.e., the degree of differentiation of executive functions).     

The Impact of Ruminative Processing on the Experience of Self-Referent Intrusive Memories in Dysphoria

The current study sought to experimentally assess the differential effects of analytical ruminative processing and distraction on the experience of self-referent naturally occurring intrusive memories in a sample of dysphoric (BDI-II ≥ 12) participants. Seventy-seven undergraduate participants completed a memory interview to elicit details about a self-referential intrusion and were randomly assigned to either an analytical rumination or distraction condition. Subsequent to the rumination induction, participants rated their intrusive memory as more negative, more distressing, and more evocative of a negative emotional response compared to participants who were allocated to the distraction induction. Inducing analytical rumination also resulted in participants reporting worse (i.e., more sad) mood relative to those in the distraction condition. The findings align with the suggestion that depressed individuals may get caught up in a ruminative cycle that, due to the documented effects of analytical self-focus, exacerbate the emotional response elicited by intrusions and perpetuate biased attentional focus on them. Directions for future investigations of the cognitive processes that are important in the maintenance of intrusions in depressive disorders are discussed.     

Successfully controlling intrusive memories is harder when control must be sustained

After unpleasant events, people often experience intrusive memories that undermine their peace of mind. In response, they often suppress these unwanted memories from awareness. Such efforts may fail, however, when inhibitory control demands are high due to the need to sustain control, or when fatigue compromises inhibitory capacity. Here we examined how sustained inhibitory demand affected intrusive memories in the Think/No-Think paradigm. To isolate intrusions, participants reported, trial-by-trial, whether their preceding attempt to suppress retrieval had triggered retrieval of the memory they intended to suppress. Such counter-intentional retrievals provide a laboratory model of the sort of involuntary retrieval that may underlie intrusive memories. Using this method, we found that longer duration trials increased the probability of an intrusion. Moreover, on later No-Think trials, control over intrusions suddenly declined, with longer trial durations triggering more relapses of items that had been previously been purged. Thus, the challenges of controlling retrieval appear to cause a decline in control over time, due to a change in state, such as fatigue. These findings raise the possibility that characteristics often true of people with psychiatric disorders – such as compromised sleep, and increased demand on control – may contribute to difficulties in suppressing intrusive memories.     

“Why” or “How”: The Effect of Concrete Versus Abstract Processing on Intrusive Memories Following Analogue Trauma

Emergency service workers, military personnel, and journalists working in conflict zones are regularly exposed to trauma as part of their jobs and suffer higher rates of posttraumatic stress compared with the general population. These individuals often know that they will be exposed to trauma and therefore have the opportunity to adopt potentially protective cognitive strategies. One cognitive strategy linked to better mood and recovery from upsetting events is concrete information processing. Conversely, abstract information processing is linked to the development of anxiety and depression. We trained 50 healthy participants to apply an abstract or concrete mode of processing to six traumatic film clips and to apply this mode of processing to a posttraining traumatic film. Intrusive memories of the films were recorded for 1 week and the Impact of Events Scale–Revised (IES-R; Weiss & Marmar, 1997) was completed at 1-week follow-up. As predicted, participants in the concrete condition reported significantly fewer intrusive memories in response to the films and had lower IES-R scores compared with those in the abstract condition. They also showed reduced emotional reactivity to the posttraining film. Self-reported proneness to intrusive memories in everyday life was significantly correlated with intrusive memories of the films, whereas trait rumination, trait dissociation, and sleep difficulties were not. Findings suggest that training individuals to adopt a concrete mode of information processing during analogue trauma may protect against the development of intrusive memories.