Towards a cognitive-behavioral model of PTSD in children and adolescents

Posttraumatic stress disorder in children and adolescents has been studied only for the past 15–20 years and is the subject of a burgeoning corpus of research. Much research has focused on examining whether children and adolescents have the same responses to trauma as those experienced by adults. Many of the research tools used to investigate children's responses are taken from measures designed for use with adults, and these measures have proven to be useful. However, it has not been established that children's responses to traumatic events are related to the same underlying processes as are adults' responses. The possible application of 2 recent cognitive models of PTSD in adults to understanding PTSD in children and adolescents is discussed in this paper, within the context of what is already known about children's reaction to trauma and existing theoretical accounts of childhood PTSD. Particular attention is paid toward the nature of children's memories of traumatic events and how these memories relate to the reexperiencing symptoms of PTSD, and cognitive processes that may play a role in the maintenance of PTSD. It is proposed that the adoption of a more specific cognitive–behavioral framework in the study of this disorder may be beneficial and lead to better treatment outcomes.     

Out of one's mind: a study of involuntary semantic memories

The study of memories that pop into one's mind without any conscious attempt to retrieve them began only recently. While there are some studies on involuntary autobiographical memories (e.g., ) research on involuntary semantic memories or mind-popping is virtually non-existent. The latter is defined as an involuntary conscious occurrence of brief items of one's network of semantic knowledge. The recall of these items (e.g., a word, a name, a tune) is not accompanied by additional contextual information and/or involvement of self-a standard feature of involuntary autobiographical memories. The paper reports several diary and questionnaire studies which looked into the nature and frequency of occurrence of these memories. The data show that people do experience involuntary semantic memories which tend to occur without any apparent cues while being engaged in relatively automatic activities. Possible mechanisms of involuntary semantic memories are discussed (e.g., very long-term priming), and the results of the study provide information on the possible duration of the priming effects in everyday life. Related theoretical and methodological issues and future avenues of research in this neglected area are outlined.     

Current concerns in involuntary and voluntary autobiographical memories

Involuntary autobiographical memories are conscious memories of personal events that come to mind with no preceding attempts at retrieval. It is often assumed that such memories are closely related to current concerns – i.e., uncompleted personal goals. Here we examined involuntary versus voluntary (deliberately retrieved) autobiographical memories in relation to earlier registered current concerns measured by the Personal Concern Inventory (PCI; Cox & Klinger, 2000). We found no differences between involuntary and voluntary memories with regard to frequency or characteristics of current concern-related contents. However, memories related to current concerns were rated as more central to the person’s identity, life story and expectations for the future than non-concern-related memories, irrespective of mode of recall. Depression and PTSD symptoms correlated positively with the proportion of current concern-related involuntary and voluntary memories. The findings support the view that involuntary and voluntary remembering is subject to similar motivational constraints.     

Enhanced perceptual priming for neutral stimuli occurring in a traumatic context: two experimental investigations

Intrusive memories in posttraumatic stress disorder are often triggered by stimuli that are perceptually similar to those present shortly before or during the trauma. The present study aims to examine the possible role of perceptual priming in this phenomenon. It further investigates whether the degree of perceptual priming is associated with dissociation and whether both perceptual priming and intrusive memories can be reduced through elaboration. Two experiments measured perceptual priming for neutral stimuli that immediately preceded a "traumatic" event. Volunteers (N=46, 92) watched a series of "traumatic" and neutral picture stories, and completed a blurred object identification (perceptual priming) memory task, and a recognition memory task. Participants in Experiment 1 were selected to score either high or low on the Trait Dissociation Questionnaire [Murray, Ehlers, & Mayou (2002). Dissociation and posttraumatic stress disorder: Two prospective studies of motor vehicle accident survivors. British Journal of Psychiatry, 180, 363-368]. They also completed a state dissociation measure in the session. Experiment 2 randomly allocated participants to an experimental condition designed to increase elaboration or to a control condition. This experiment also included a measure of intrusive memories. Both experiments found enhanced perceptual priming for the stimuli that immediately preceded the "traumatic" stories compared to those preceding neutral stories. Participants with high trait dissociation showed relatively stronger perceptual perceptual priming. The degree of perceptual priming for stimuli from the "traumatic" stories also correlated with state dissociation (Experiment 1). Experimental manipulation of the elaboration of the stories showed that elaboration reduced the enhanced perceptual priming effect and the relative probability of reexperiencing symptoms (Experiment 2). The results support the role of perceptual priming in intrusions after traumatic events.