Mental imagery in adolescent PTSD patients after child abuse: a comparison with matched healthy controls

Abstract

Background Intrusive mental imagery (MI) plays a crucial role in the maintenance of posttraumatic stress disorder (PTSD) in adults. Evidence on the characteristics of MI in adolescents suffering from PTSD is sparse. The aim of this study was to thoroughly assess MI in an adolescent sample suffering from PTSD after the experience of childhood sexual abuse and/or childhood physical abuse (CA). Methods Thirty-two adolescents with a primary diagnosis of PTSD after CA and 32 adolescents without any mental disorder and without a history of CA, matched for age and gender, completed questionnaires assessing the characteristics of negative and positive MI, as well as images of injury and death that lead to positive emotions (ID-images). Results The PTSD group reported significantly more frequent, more vivid, more distressing and more strongly autobiographically linked negative MI compared to the control group. Although positive MI was highly present in both groups (PTSD: 65.6%; controls: 71.9%), no significant differences emerged between the two groups regarding the distinct characteristics of positive MI. The frequency of the ID-images did not significantly differ between the two groups (PTSD: 21.9%; controls: 9.4%), although the ID-images were more vivid in the PTSD group. Discussion Negative MI appears to be crucial in adolescent PTSD, whilst positive MI are unexpectedly common in both the PTSD and the control group. The role of positive MI as well as that of ID-images remain unclear. Specific interventions for changing negative MI that are tailored to the developmental challenges in adolescents with PTSD should be developed. Trial registration Some of the PTSD patients in this study were also part of a randomized controlled trial on Developmentally adapted Cognitive Processing Therapy (D-CPT). This trial was registered at the German Clinical Trial Registry (GCTR), DRKS00004787, 18 March 2013.

Narrative-based autobiographical memory interventions for PTSD: a meta-analysis of randomized controlled trials

“…This process dramatically 10.3389/fpsyg.2023.1215225 Frontiers in Psychology 21 frontiersin.org altered the mental rehearsals for their prospective future and most likely contributed substantially to the maintenance of PTSD symptoms. This line of research is also supported by preliminary evidence from Steil et al (2022), in which findings indicated that individuals with PTSD from childhood abuse had a significantly higher degree of intrusive negative mental imagery compared to healthy subjects -although these results should be interpreted with caution due to several potentially confounding variables (e.g., education levels, immigration status, and general intelligence). However, it is also well-established that individuals with clinical depression and co-occurring suicidal ideations also experience intrusive mental imagery, which could be considered flashforwards, in which they exhibit increased mental images of selfharm, their own death, or the death of a loved one (Holmes et al, 2007;Ng et al, 2016;Schultebraucks et al, 2020).…”

Mental Imagery in the Relationship between Alexithymia and Parental Psychological Control

“…Among adolescents diagnosed with post-traumatic stress disorder who had experienced child abuse, including physical abuse by a parent or caregiver, reported significantly higher frequencies of negative mental imagery. These images were characterized as being more vivid, distressing, and tightly intertwined with their autobiographical memories [ 48 ]. However, the vividness of parental mental imagery was positively associated with both parental acceptance of the child and autonomy support, along with various aspects of the climate for creativity in the parent–child relationship [ 49 ].…”