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Maintenance of Intrusive Memories in Posttraumatic Stress Disorder: A Cognitive Approach

Published online by Cambridge University Press:  16 June 2009

Anke Ehlers  and
Regina Steil
Anke Ehlers
Affiliation:
University of Oxford
Regina Steil
Affiliation:
University of Göttingen, Germany
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Abstract

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Intrusive recollections are very common immediately after traumatic events and are considered necessary aspects of emotional processing. However, if these intrusive recollections persist over a long time, they are linked to long-term psychiatric disorder, especially Posttraumatic Stress Disorder (PTSD). This paper discusses the need to investigate factors involved in the maintenance of intrusive traumatic recollections. It is suggested that the idiosyncratic meaning of the intrusive recollections predicts the distress caused by them, and the degree to which the individual engages in strategies to control the intrusions. These control strategies maintain the intrusive recollections by preventing a change in the meaning of the trauma and of the traumatic memories. It is further suggested that what is needed is a comprehensive assessment of the processes that prevent change in meaning, going beyond the assessment of avoidance. In particular, safety behaviours, dissociation and numbing, suppression of memories and thoughts about trauma, rumination, activation of other emotions such as anger and guilt and corresponding cognitions, and selective information processing (attentional and memory biases) may be involved in the maintenance of intrusive recollections. Preliminary data supporting these suggestions from studies of individuals involved in road traffic accidents and survivors of child sexual abuse are described.

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 23 , Issue 3 , July 1995 , pp. 217 - 249
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1995

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