Solving the mystery of intrusive flashbacks in posttraumatic stress disorder: Comment on Brewin (2014).

Abstract

In the light of current controversy about the nature of intrusions in posttraumatic stress disorder (PTSD), the review by Brewin (2014) is timely and important. It will undoubtedly stimulate further research and guide researchers' quests for understanding the nature of flashbacks in PTSD. In this commentary, I briefly summarize and discuss key points made by Brewin and elaborate on some of the reasons behind the controversy. For example, the terms involuntary autobiographical memories, intrusive memories, and flashbacks are often used interchangeably. I propose a taxonomy revealing the key differences across these forms of memory. If flashbacks are characteristic of patients with PTSD only, it is essential that more research targeting this population is conducted with a variety of methods. Finally, some new avenues for research to study intrusive memories and flashbacks in PTSD, using a diary method and modified trauma film paradigm, are described.

First steps in using machine learning on fMRI data to predict intrusive memories of traumatic film footage

“…However, we note that intrusive memories experienced after traumatic events and intrusive memories in everyday life (such as those in our experimental procedure) can be considered on a continuum (Kvavilashvili, 2014). Additionally, PTSD symptoms have been reported following exposure to traumatic media footage (Holman et al., 2014; Silver et al., 2013).…”

“…However, no measure of dissociation was taken in the current study and thus we could not examine any possible effects of dissociation to the current work. A continuum has been proposed ranging from involuntary autobiographical memories in everyday life to recurrent intrusive memories and in the most extreme (and rarest) form dissociative flashbacks (Kvavilashvili, 2014). Investigating dissociation in combination with fMRI is therefore an important step for future work (e.g.…”

“…Thus, key features of intrusive memories are that they are involuntary rather than deliberately retrieved, i.e. apparently spontaneous (Kvavilashvili, 2014); include perceptual aspects of the traumatic event, i.e. involve mental imagery rather than only verbal thought (Holmes, Grey, & Young, 2005); are in line with episodic and memory recall more broadly (Conway, 2001), and have distressing, i.e.…”

Nonconventional interventions for chronic post-traumatic stress disorder: Ketamine, repetitive trans-cranial magnetic stimulation (rTMS), and alternative approaches

“…It has been argued that both flashbacks and A c c e p t e d M a n u s c r i p t 9 intrusive memories, the two major symptoms of PTSD, may be due to failure of the extinction mechanism associated with fear conditioning which is a glutamate dependent process (Falls, Miserendino, & Davis, 1992;Kvavilashvili, 2014). This provides a strong theoretical rationale for the use of ketamine to decrease the fear conditioning and to ameliorate the recall/reexpression of traumatic memories, the core psychopathology seen in PTSD.…”

A DSM Comparative Study of PTSD Incidence in Indonesia

“…Importantly, there is significant disagreement among psychological and medical professionals as to the accuracy or efficacy of either of the major taxonomical systems (Chafee, 2012;Frueh, Elhai, & Acierno, 2010;Kvavilashvili, 2014;Rose, Spitzer & McHugh, 2008). The debate over the reliability of the nosology for clinical use centers on issues of missing unclassified features or, importantly, the unmentioned cluster, interpersonal issues (Cloitre, et al, 2013;Iverson et.…”