How expectations shape the formation of intrusive memories – An experimental study using the trauma film paradigm

Abstract

Objective: Although intrusions are the hallmark symptom of Posttraumatic Stress Disorder (PTSD), there is still limited knowledge about the processes that contribute to the development of intrusions. Here, we used the well-established trauma film paradigm (TFP) to investigate how expectations about the intensity and controllability of intrusions influence their occurrence. Methods: 90 healthy participants underwent the TFP before they were randomized to one of three conditions manipulating their expectations about intrusions: positive expectations group; negative expectations group; control group. The primary outcome was the frequency and severity of intrusive memories as assessed with an intrusion diary over seven days.Results: The TFP was well implemented, as indicated by significant post-film anxiety and a substantial number of intrusions reported for the subsequent week. The three groups did not differ in their expectations about intrusions and, relatedly, in their experience of intrusions. A mediation analysis revealed that the influence of post-film anxiety on intrusive memories was fully mediated by expectations. Conclusion: Despite the failure of the expectation manipulation, the results of the mediation analysis support the hypothesis that post-film expectations influence the formation of intrusive memories, suggesting that intrusions may result from maladaptive dynamics between emotional and cognitive processes following trauma(like) experiences.

Is it worth it to personalize the treatment of PTSD? – A variance-ratio meta-analysis and estimation of treatment effect heterogeneity in RCTs of PTSD

“…Fourth, since treatment types did not differ markedly between each other in their heterogeneity of treatment effects, future studies should examine specific ingredients of psychological treatments to investigate if there are different underlying mechanisms of change and possible component-level sources of TEH. For example, the role of dysfunctional expectations in PTSD was recently highlighted by empirical (Herzog, Barth, et al, 2021;Herzog, Kaiser, et al, 2021) and conceptual studies (Kube et al, 2020), suggesting that expectation violation might be involved as a mechanism across treatment modalities.…”