调控去甲肾上腺素能系统对防治创伤后应激障碍的影响

个体经历严重创伤性事件后可能会形成创伤后应激障碍(posttraumatic stress disorder, PTSD)。在创伤经历中形成的情绪记忆是以后发展为PTSD的重要病理机制。PTSD的形成涉及到情绪记忆的过度巩固, 而去甲肾上腺素能神经信号可增强情绪记忆的巩固和再巩固。因此, 在创伤记忆的巩固和再巩固期间阻断去甲肾上腺素能神经信号, 而在创伤记忆的消退期间增强去甲肾上腺素能神经信号, 可能会破坏和或抑制病理性的情绪记忆, 从而预防或治疗PTSD。     

Associations between Thematic Content and Memory Detail in Trauma Narratives

This study examined whether thematic content (e.g., fear, anger, alienation, self‐blame, and spirituality) in trauma narratives predicted memory detail. Trauma‐specific memory models suggest that trauma narrative themes are associated with much sensory detail; general autobiographical memory models suggest that themes are associated with little context detail. Seventy‐one narratives from a diverse community sample exposed to a variety of traumatic events (e.g., sexual assault, natural disasters) were coded for themes and detail. Analyses controlled for narrative length, childhood or adulthood occurrence, self‐reported post‐traumatic stress disorder, depression and dissociation symptoms. Fear themes were associated with greater sensory detail; anger and spirituality themes were associated with less context detail. Findings support a link between thematic content and detail, and may partially explain why details in memory for traumatic events sometimes appear better and other times worse than memory for other events. Memory models may benefit from specification based on themes in trauma narratives. Copyright © 2013 John Wiley & Sons, Ltd.     

Memory of the traumatic event as a risk factor for the development of PTSD: lessons from the study of traumatic brain injury

Traumatic memories, and the mechanisms by which they operate, continue to occupy a central role in the scientific investigation of risk factors for the development of posttraumatic stress disorder (PTSD). However, empirically based studies are constrained by practical and ethical considerations and are limited to naturalistic models. Consequently, the paradigms most appropriate for the exploration of the relationship between traumatic memories and PTSD have been identified in conditions involving traumatic events where memories may be compromised. Indeed, traumatic brain injury, a condition that is commonly associated with memory impairment, has often been utilized as a naturally occurring model for the study of traumatic memory and its contribution to the development of PTSD. This article presents a critical review of these research efforts and discusses their theoretical and clinical implications.     

A longitudinal investigation of the reliability of memories for trauma and other emotional experiences

This study examined the relative consistency and characteristics of memories for trauma and other non‐traumatic emotional experiences over time. A community sample of 52 participants who reported a recent traumatic event were asked to recall both the traumatic and a positive emotional experience in two interviews separated by approximately three months (M = 105.39 days). The recollections were elicited with either a free narrative, cognitive interview, guided imagery, or written narrative approach. Results indicated that traumatic experiences were recalled more reliably over time than other emotional experiences. Traumatic memory imagery tended to persist in memory (with no apparent impairment), whereas features of positive memories were subject to considerable distortion, regardless of interview style. The findings contribute to the understanding of the impact of trauma on memory with the passage of time. Copyright © 2004 John Wiley & Sons, Ltd.     

Stability of emotions for traumatic memories in acute and chronic PTSD

While memory for central factual information regarding an emotional event is considered to be relatively accurate, memory for emotions seem to be quite inaccurate (Christianson & Safer, 1995). We extended this line of research to examine memory for the emotional intensity surrounding a traumatic event (e.g., memory for the fear and horror of the event). We conducted a series of two studies. In Study 1, we examined memory for the emotional intensity of the traumatic event in recent sexual or non-sexual assault victims with acute PTSD at 2 and 12 weeks following the assault. In Study 2, we compared memory for emotional intensity in sexual and non-sexual assault victims with either acute or chronic PTSD at initial assessment and 12 weeks later. For both studies, participants were asked to recall general emotional intensity, fear intensity, and dissociative intensity of the traumatic event. Results suggested that memory for the fear of the traumatic event did not fluctuate over time. However, memory for the general emotional and dissociative intensity did fluctuate over time, decreasing for individuals with acute PTSD and increasing for individuals with chronic PTSD.     

A 2‐year‐old child's memory of hospitalization during early infancy

A child who had had surgery at 5 months of age, and who had been treated at the time for post‐traumatic symptoms (reported in a previous paper by the author), was interviewed 2 years later and almost 3 years later to test for possible verbal recall of his hospitalization. He appeared to have some memories of the experience at 29 months of age, and he was able to superimpose verbal labels onto the preverbal memories. At 40 months of age, however, the memories were no longer verbally accessible. The results are discussed in the context of different theories of encoding, storage, retrieval, and loss of early memories. The findings from this study support other findings indicating that there appears to be some form of long‐term memory in place early in life, at least for highly salient, traumatic events. There may be one memory system for traumatic memories, fully functional at birth, and a later developing, different system for neutral memories. It is further hypothesized that there may be a sensitive period around 2–3 years of age for the recall of early traumatic memories, and that verbal recall is more likely to be present in verbally precocious children during that period. Copyright © 2008 John Wiley & Sons, Ltd.     

Tunnel memory for traumatic events

In four experiments subjects remembered the critical information in a traumatic slide as either more focused spatially than in its original presentation or more focused spatially than information in a matched neutral slide. Subjects comprehend a neutral scene by automatically extending its boundaries and understanding the visual information in a broader external context. However, when subjects are negatively aroused by a scene, they process more elaborately those critical details that were the source of the emotional arousal, and they maintain or restrict the scene's boundaries. ‘Tunnel memory’ results from this greater elaboration of critical details and more focused boundaries. Tunnel memory may explain the superior recognition and recall of central, emotion-arousing details in a traumatic event, as shown in previous research on emotion and memory. © 1998 John Wiley & Sons, Ltd.     

‘Comparisons of traumatic and positive memories in people with and without PTSD profile’

According to most post‐traumatic stress disorder (PTSD) theories, memory mechanisms are involved in its development and maintenance. However, the specific memory characteristics responsible for this disorder are still not well known. In the present study, 210 participants having reported at least one traumatic experience were assigned to a PTSD or to a non‐PTSD symptom profile group. Both groups rated their memories for their most traumatic and intense positive life events. We observed that the traumatic memories of PTSD profile participants were more clear, detailed and judged as significant compared with those of the non‐PTSD profile group. However, participants in the first group acknowledged having more difficulties putting their traumatic memories into words and controlling these remembrances. These differences were absent in their positive memories. Additionally, clear relationships emerged between memory ratings and PTSD symptoms measures. Results are discussed according to fragmentation and superiority views of traumatic memories in PTSD. Copyright © 2006 John Wiley & Sons, Ltd.     

Predictors of Accurate and Inaccurate Memories of Traumatic Events Experienced in Childhood

How likely is it that traumatic childhood events are misremembered or forgotten? Research on children′s recollections of painful or frightening medical procedures may help answer this question by identifying predictors of accurate versus inaccurate memory. In the present study, 46 3- to 10-year-old children were interviewed after undergoing a stressful medical procedure involving urethral catheterization. Age differences in memory emerged, especially when comparing 3- to 4-year-olds with older children. Children′s understanding of the event, parental communication and emotional support, and children′s own emotional reactions also predicted accuracy. Memory did not reliably vary for children who endured the medical procedure once versus multiple times. Results are discussed in relation to possible precursors of accurate and false memories, and forgetting, of traumatic events experienced in childhood.     

Effects of stress hormones on traumatic memory formation and the development of posttraumatic stress disorder in critically ill patients

A majority of patients after intensive care treatment report traumatic memories from their stay in the intensive care unit (ICU). Traumatic memories can be associated with the development of posttraumatic stress disorder (PTSD) in a subpopulation of these patients. In contrast to other patient populations at risk for PTSD, patients in the ICU often receive exogenously administered stress hormones like epinephrine, norepinephrine, or cortisol for medical reasons and are extensively monitored. ICU patients therefore represent a suitable population for studying the relationship between stress hormones, traumatic memories, and the development of PTSD. Studies in long-term survivors of ICU treatment demonstrated a clear and vivid recall of different categories of traumatic memory such as nightmares, anxiety, respiratory distress, or pain with little or no recall of factual events. The number of categories of traumatic memory recalled increased with the total administered dosages of stress hormones (both catecholamines and cortisol), and the evaluation of these categories at different time points after discharge from the ICU showed better memory consolidation with higher dosages of stress hormones administered. However, the administration of stress doses of cortisol to critically ill patients resulted in more complex findings as it caused a significant reduction in PTSD symptoms measured after recovery. This effect can possibly be explained by a differential influence of cortisol on memory. Increased serum cortisol levels not only result in consolidation of emotional memory but are also known to cause a temporary impairment in memory retrieval which appears to be independent of glucocorticoid effects on memory formation. Disrupting retrieval mechanisms with glucocorticoids during critical illness may therefore act protectively against the development of PTSD by preventing recall of traumatic memories. Our findings indicate that stress hormones influence the development of PTSD through complex and simultaneous interactions on memory formation and retrieval. Our studies also demonstrate that animal models of aversive learning are useful in analyzing and predicting clinical findings in critically ill humans.     

Similarities and differences between traumatic and emotional memories: review and directions for future research

The authors review theory and empirical research on the characteristics of memories for traumatic versus emotional events, with the goal of bringing together the cognitive and clinical perspectives on this issue. They consider the most important approaches to the study of traumatic and emotional memory and summarize the results of recent studies that have compared autobiographical recollections of traumatic and nontraumatic emotional experiences (positive and negative), either in nonclinical or clinical samples. Overall, findings from the current empirical literature are inconsistent. Although some researchers have found that traumatic memories are retrieved differently than are emotional memories, others have demonstrated that the phenomenological characteristics of these memory types are highly similar. The authors discuss methodological issues that could help researchers to interpret the inconsistencies found in the empirical findings. Last, they suggest possible directions for future research that may advance researchers' knowledge of memory, trauma, and emotion.     

MEMORY ALTERING TECHNOLOGIES AND THE CAPACITY TO FORGIVE: WESTWORLD AND VOLF IN DIALOGUE

I explore the impact of memory altering technologies in the science fiction drama (2016–2020) in order to show that unreconciled altered traumatic memory may lead to a dystopian breakdown of society. I bring Miroslav Volf's theological perspectives on memory into conversation with the plot of Westworld in order to reveal connections between memory altering technologies and humanity's responsibility to remember rightly. Using Volf's theology of remembering as an interpretive lens, I analyze characters’ inability to remember rightly while recalling partial memories of their trauma. In virtue of this examination, I contend that memory altering technologies may inhibit individuals from relational processes of healing, such as forgiveness. Consequently, I argue that this study leads to a richer understanding of the potential that memory altering technologies have for undermining humanity's ability to interact in a relational capacity, specifically in terms of forgiveness.     

Acoustic resonance at the dawn of life: musical fundamentals of the psychoanalytic relationship

This paper uses a case vignette to show how musical elements of speech are a crucial source of information regarding the patient's emotional states and associated memory systems that are activated at a given moment in the analytic field. There are specific psychoacoustic markers associated with different memory systems which indicate whether a patient is immersed in a state of creative intersubjective relatedness related to autobiographical memory, or has been triggered into a traumatic memory system. When a patient feels immersed in an atmosphere of intersubjective mutuality, dialogue features a rhythmical and tuneful form of speech featuring improvized reciprocal imitation, theme and variation. When the patient is catapulted into a traumatic memory system, speech becomes monotone and disjointed. Awareness of such acoustic features of the traumatic memory system helps to alert the analyst that such a shift has taken place informing appropriate responses and interventions. Communicative musicality (Malloch & Trevarthen 2009) originates in the earliest non‐verbal vocal communication between infant and care‐giver, states of primary intersubjectivity. Such musicality continues to be the primary vehicle for transmitting emotional meaning and for integrating right and left hemispheres. This enables communication that expresses emotional significance, personal value as well as conceptual reasoning.     

Block of glucocorticoid synthesis during re-activation inhibits extinction of an established fear memory

BackgroundThe pharmacology of traumatic memory extinction has not been fully characterized despite its potential as a therapeutic target for established, acquired anxiety disorders, including post-traumatic stress disorder (PTSD). Here we examine the role of endogenous glucocorticoids in traumatic memory extinction.MethodsMale C57BL/6J mice were injected with corticosterone (10 mg/kg, i.p.) or metyrapone (50 mg/kg, s.c.) during re-activation of a contextual fear memory, and compared to vehicle groups (N = 10–12 per group). To ensure that metyrapone was blocking corticosterone synthesis, we measured corticosterone levels following re-activation of a fear memory in metyrapone- and vehicle-treated animals.ResultsCorticosterone administration following extinction trials caused a long-lasting inhibition of the original fear memory trace. In contrast, blockade of corticosteroid synthesis with metyrapone prior to extinction trials enhanced retrieval and prevented extinction of context-dependent fear responses in mice. Further behavioral analysis suggested that the metyrapone enhancement of retrieval and prevention of extinction were not due to non-specific alterations in locomotor or anxiety-like behavior. In addition, the inhibition of extinction by metyrapone was rescued by exogenous administration of corticosterone following extinction trials. Finally, we confirmed that the rise in corticosterone during re-activation of a contextual fear memory was blocked by metyrapone.ConclusionsWe demonstrate that extinction of a classical contextual fear memory is dependent on endogenous glucocorticoid synthesis during re-activation of a fear memory. Our data suggest that decreased glucocorticoids during fear memory re-activation may contribute to the inability to extinguish a fear memory, thus contributing to one of the core symptoms of PTSD.     

Effects of stress on recall

Subjects in experimental conditions were exposed to a traumatic autopsy colour slide (labelled either as of New York Police Department (NYPD) or MGM studio origin) embedded in a neutral series of travel scenes, while control subjects saw a neutral target. Subjects in the high-stress condition showed a significant decrease in memory for neutral slides which followed the NYPD-labelled traumatic stimulus (p < 0.001). Results support evidence in the eyewitness memory field which indicate reduced recall under elevated levels of stress.     

False Memories for an Analogue Trauma: Does Thought Suppression Help or Hinder Memory Accuracy?

In the current study, we investigated whether suppression can produce an amplified memory for a traumatic experience. Participants viewed a distressing film depicting a multi‐fatality car accident. We broke the film down into several short clips, some of which were removed. After viewing the film, we instructed participants to (i) suppress and monitor film‐related thoughts, (ii) think freely and monitor film‐related thoughts or (iii) just think freely. Twenty‐four hours later, participants completed a recognition test. Memory distortion was comparable across conditions; however, suppression and monitoring of trauma‐related thoughts removed the typical bias to falsely remember the most critical and traumatic clips of the film over the least critical clips. Our data suggest that suppression may be effective in reducing trauma‐related cognitions and, therefore, does not predict a more ‘amplified’ memory for trauma. Instead, suppression and thought monitoring encourage an unbiased, although inaccurate, memory for trauma.Copyright © 2016 John Wiley & Sons, Ltd.     

The impact of depression and PTSD symptom severity on trauma memory

Posttraumatic stress disorder (PTSD) and depression frequently co-occur following a traumatic event. Differences in the processing of autobiographical memory have been observed in both disorders in the form of overgeneralised memories and negative intrusive memories. The current study examined how symptoms of PTSD and depression influence the phenomenological characteristics of trauma memories. Undergraduate students who had experienced a traumatic event (n?=?696) completed questionnaires online including measures of PTSD and depressive symptom severity. They rated their trauma memory on several phenomenological characteristics using the Memory Experiences Questionnaire [Sutin, A. R., &; Robins, R. W. (2007). Phenomenology of autobiographical memories: The memory experiences questionnaire. Memory.]. Moderated multiple regression was used to examine how PTSD and depressive symptom severity related to each phenomenological characteristic. Symptoms of PTSD and depression were related separately and uniquely to the phenomenological characteristics of the trauma memory. PTSD severity predicted trauma memories that were more negative, contained higher sensory detail, and were more vivid. In contrast, depressive symptom severity predicted trauma memories that were less accessible and less coherent. These findings suggest that depressive and PTSD symptomatology affect traumatic memory differently and support a distinction between these two disorders.     

Characteristics of memories for traumatic and nontraumatic birth

Evidence for memory characteristic differences between trauma and other memories in non‐clinical samples is inconsistent. However, trauma is frequently confounded with the event recalled. This study compares trauma and nontrauma memories for the same event, childbirth, in a non‐clinical sample of 285 women 4–6 weeks after birth. None of the women met diagnostic criteria for post‐traumatic stress disorder. Traumatic birth, defined by the DSM‐5 event criterion, was reported by 100 women. The ratings of some memory characteristics did not differ between memories for traumatic and nontraumatic birth: All were rated highly coherent and central to women's lives, with moderate sensory memory. However, women who experienced traumatic births reported more involuntary recall, reliving, and negative/mixed emotions. Thus, trauma memories differed from nontrauma memories. In this non‐clinical sample, this is likely to be due to encoding during trauma rather than the distinctive memory profile for memories retrieved by those experiencing trauma symptoms.     

Exploring the Nature of Traumatic Memory

Summary

For over 100 years clinicians have observed and described the unusual nature of traumatic memories. It has been repeatedly and consistently observed that these memories are characterized by fragmentary and intense sensations and affects, often with little or no verbal narrative content. Yet, possibly because traumatic memories cannot be precipitated under laboratory conditions, the organization of traumatic memories has received little systematic scientific investigation. In our laboratory we have developed an instrument, the Traumatic Memory Inventory (TMI), which systematically assesses the ways that memories of traumatic experience are organized and retrieved over time. In this article we report findings from our third study using the TMI, of 16 subjects who had the traumatic experience of awakening from general anesthesia during surgery. We assessed changes in traumatic memory characteristics over time and differences between memories of subjects with and without current Post-Traumatic Stress Disorder. Our findings suggest the need for more rigorous methods for the assessment of the evolution of traumatic memories. In order to develop a comprehensive and integrated understanding of the nature of traumatic memory, we need to combine careful clinical observations with repli-cable laboratory methods, including those of cognitive science and neuroscience.     

Seeking the Core: The Issues and Evidence Surrounding Recovered Accounts of Sexual Trauma

This review identifies some of the many layers that surround and potentially obscure the emotionally charged topic of recovered accounts of childhood abuse. Consideration of the, admittedly often indirect, evidence provides suggestive support for many of the components of both recovered and fabricated memories of abuse. With respect to recovered memories the available evidence suggests that: (1) although the prior accessibility of a memory may be difficult to determine, recovered memory reports can sometimes be corroborated with respect to their correspondence to actual abuse; (2) although individuals often retain memory for trauma, there is evidence for fluctuations in the accessibility of traumatic experiences, particularly for situations that are extremely difficult to talk about; (3) there are compelling mechanisms available to account for both the decreases and the subsequent increases in accessibility of traumatic memories that could lead to recovered memory reports. With respect to fabricated memories the available evidence suggests that: (1) people are highly capable of fabricating vivid recollections that can be confused with reality; (2) once fabricated, there seems to be no limit to the preposterous false memories that some individuals are capable of accepting particularly when in the presence of a persuasive individual in a position of authority. Although future research is needed to provide more direct evidence for the above claims, at present readers are urged to consider the strong likelihood that both recovered and fabricated memories correspond to real phenomena.