Intrusive images and intrusive thoughts as different phenomena: Two experimental studies

According to the dual representation theory of PTSD, intrusive trauma images and intrusive verbal thoughts are produced by separate memory systems. In a previous article it was shown that after watching an aversive film, participants in non-movement conditions reported more intrusive images than participants in a free-to-move control condition (Hagenaars, Van Minnen, Holmes, Brewin, & Hoogduin, 2008). The present study investigates whether the experimental conditions of the Hagenaars et al. study had a different effect on intrusive thoughts than on intrusive images. Experiment 2 further investigated the image–thoughts distinction by manipulating stimulus valence (trauma film versus neutral film) and assessing the subsequent development of intrusive images and thoughts. In addition, both experiments studied the impact of peri-traumatic emotions on subsequent intrusive images and thoughts frequency across conditions. Results showed that experimental manipulations (non-movement and trauma film) caused higher levels of intrusive images relative to control conditions (free movement and neutral film) but they did not affect intrusive thoughts. Peri-traumatic anxiety and horror were associated with subsequent higher levels of intrusive images, but not intrusive thoughts. Correlations were inconclusive for anger and sadness. The results suggest intrusive images and thoughts can be manipulated independently and as such can be considered different phenomena.