Can Imaginal Exposure Reduce Intrusive Memories in Depression? A Case Study

BACKGROUND Additional interventions are needed for survivors of psychological trauma. Case studies can help treatment innovation with an intervention designed to disrupt memory reconsolidation, taking a single symptom approach by focusing on intrusive memories of a traumatic event. OBJECTIVE We aimed to examine a novel brief cognitive intervention to reduce the number of intrusive memories of trauma, in an Icelandic setting and extending previous studies by examining longer-term effects up to 3 months. The intervention comprised a brief memory reminder, then Tetris gameplay with mental rotation, targeting one memory at a time in each session. The intervention was guided by a clinical psychologist and adapted to the Icelandic setting. METHODS This was a single case study in Iceland with a woman in her fifties, with 4 different intrusive memories from childhood. The primary outcome was the change in number of intrusive memories from baseline to intervention phase, and to follow-ups. The number of intrusions was monitored in a daily diary for: 4 weeks preintervention; 8 weeks during intervention; 1 week at 1-month and 3-month follow-ups. Intrusions were targeted one-by-one over 6 intervention sessions, creating 4 repetitions of an AB design (i.e., length of baseline ‘A’ and intervention phase ‘B’ varied for each memory). We examined change in both total number of intrusions (summed across all 4 memories) and individually for each memory. RESULTS The number of total intrusions per week was 12.6 at baseline; 6.1 over the intervention phase (a 52% reduction from baseline); 3.0 at the 1-month follow-up (76% reduction); and 1.0 at the 3-month follow-up (92% reduction). Reductions in symptoms of posttraumatic stress and depression were observed post-intervention. Sleep, concentration, stress and functioning improved. The participant considered the gameplay intervention acceptable, and helpful in that she found the memories disappeared while playing. CONCLUSIONS This guided brief cognitive intervention reduced the number intrusive memories from over the intervention phase and follow-ups. The brief memory reminder was well-tolerated, removing the need to discuss trauma in detail. Next steps require extension to more cases and exploring remote delivery of the intervention. CLINICALTRIAL VSNb2017110046/03.01

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Feasibility of an adjunctive cognitive task in the treatment of posttraumatic stress disorder

Discover Psychology ◽

10.1007/s44202-021-00011-5 ◽

2021 ◽

Vol 1 (1) ◽

Author(s):

Amalia Badawi ◽

Zachary Steel ◽

Christopher Mahoney ◽

David Berle

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Cognitive Task ◽

Treatment Session ◽

Inpatient Setting ◽

Imaginal Exposure ◽

Intrusive Memories ◽

Feasibility Assessment ◽

Formed Part

AbstractVisuospatial cognitive tasks that influence memory reconsolidation may be of benefit in reducing intrusive memories for traumatic events when used as an adjunct to trauma-focused psychotherapy. We conducted a feasibility assessment of a protocol that involved the use of a visuospatial cognitive task, the Tetris intervention, alongside routine exposure-based treatment for posttraumatic stress disorder (PTSD). Participants were inpatients attending for PTSD treatment at a psychiatric hospital. The Tetris intervention was administered on three occasions when imaginal exposure had formed part of the treatment session. Using a phone app, participants also monitored intrusive memories over a 3-week period. Feasibility outcomes were fully met for the demand, implementation, practicality and adaptability criteria. Only a single criterion was not met for each of the acceptability and implementation criteria. Limited-efficacy testing outcomes are also discussed. Overall, the findings from our feasibility study indicated viability of the protocol, which involved implementation of the Tetris intervention alongside routine exposure-based treatment for PTSD, in a clinical inpatient setting.

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Crucial Processes in EMDRMore Than Imaginal Exposure

Journal of EMDR Practice and Research ◽

10.1891/1933-3196.2.4.262 ◽

2008 ◽

Vol 2 (4) ◽

pp. 262-268 ◽

Cited By ~ 7

Author(s):

Christopher W. Lee

Keyword(s):

Information Processing ◽

Eye Movements ◽

Exposure Therapy ◽

Symptom Improvement ◽

Information Processing Model ◽

Imaginal Exposure ◽

Trauma Research ◽

Direct Trauma ◽

Major Factors

The processes that underlie the effectiveness of eye movement desensitization and reprocessing (EMDR) are examined by evaluating the procedural differences between it and exposure therapy. Major factors include the degree of emphasis placed on reliving versus distancing in the therapies and the degree to which clients are encouraged to focus on direct trauma experiences versus experiences associated with the trauma. Research results indicate that, unlike traditional imaginal exposure, reliving responses in EMDR did not correlate with symptom improvement. Instead, consistent with an information processing model, the degree of distancing in EMDR was significantly associated with improvement. A case study is described to highlight these methodological divergences in the respective therapies relating to reliving. Finally, the research regarding the possible sources of the distancing response within EMDR was examined. The results indicate that the distancing process was more likely to be an effect produced by eye movements than by any therapist instructions. Theoretical and research evaluations indicate that the mechanisms underlying EMDR and traditional exposure therapy are different.

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Correction: Reducing Intrusive Memories of Childhood Trauma Using a Visuospatial Intervention: Case Study in Iceland

JMIR Formative Research ◽

10.2196/34897 ◽

2021 ◽

Vol 5 (11) ◽

pp. e34897

Author(s):

Kristjana Thorarinsdottir ◽

Emily A Holmes ◽

Johann Hardarson ◽

Unnur Hedinsdottir ◽

Marie Kanstrup ◽

...

Keyword(s):

Childhood Trauma ◽

Intrusive Memories

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Correction: Reducing Intrusive Memories of Childhood Trauma Using a Visuospatial Intervention: Case Study in Iceland (Preprint)

10.2196/preprints.34897 ◽

2021 ◽

Author(s):

Kristjana Thorarinsdottir ◽

Emily A Holmes ◽

Johann Hardarson ◽

Unnur Hedinsdottir ◽

Marie Kanstrup ◽

...

Keyword(s):

Childhood Trauma ◽

Intrusive Memories

UNSTRUCTURED REMOVE

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The Genesis and Internal Dynamics of El Salvador's People's Revolutionary Army, 1970–1976

Behavioral and Brain Sciences ◽

10.1017/s0140525x13009850 ◽

2014 ◽

Vol 38 (01) ◽

pp. 102-129

Author(s):

ALBERTO MARTÍN ÁLVAREZ ◽

EUDALD CORTINA ORERO

Keyword(s):

Latin America ◽

El Salvador ◽

Early Years ◽

Left Wing ◽

Internal Dynamics ◽

Internal Coherence ◽

The 1960S

AbstractUsing interviews with former militants and previously unpublished documents, this article traces the genesis and internal dynamics of the Ejército Revolucionario del Pueblo (People's Revolutionary Army, ERP) in El Salvador during the early years of its existence (1970–6). This period was marked by the inability of the ERP to maintain internal coherence or any consensus on revolutionary strategy, which led to a series of splits and internal fights over control of the organisation. The evidence marshalled in this case study sheds new light on the origins of the armed Salvadorean Left and thus contributes to a wider understanding of the processes of formation and internal dynamics of armed left-wing groups that emerged from the 1960s onwards in Latin America.

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Culture and the plasticity of perception

Behavioral and Brain Sciences ◽

10.1017/s0140525x19002887 ◽

2020 ◽

Vol 43 ◽

Author(s):

Michael Lifshitz ◽

T. M. Luhrmann

Keyword(s):

Cultural Context ◽

Sensory Experience ◽

Cultural Learning ◽

The World

Abstract Culture shapes our basic sensory experience of the world. This is particularly striking in the study of religion and psychosis, where we and others have shown that cultural context determines both the structure and content of hallucination-like events. The cultural shaping of hallucinations may provide a rich case-study for linking cultural learning with emerging prediction-based models of perception.

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Dual systems for all: Higher-order, role-based relational reasoning as a uniquely derived feature of human cognition

Behavioral and Brain Sciences ◽

10.1017/s0140525x19000451 ◽

2019 ◽

Vol 42 ◽

Author(s):

Daniel J. Povinelli ◽

Gabrielle C. Glorioso ◽

Shannon L. Kuznar ◽

Mateja Pavlic

Keyword(s):

Temporal Reasoning ◽

Higher Order ◽

Important Case ◽

Human Cognition ◽

Relational Reasoning ◽

Dual Systems ◽

First Order ◽

Reasoning System ◽

Role Based

Abstract Hoerl and McCormack demonstrate that although animals possess a sophisticated temporal updating system, there is no evidence that they also possess a temporal reasoning system. This important case study is directly related to the broader claim that although animals are manifestly capable of first-order (perceptually-based) relational reasoning, they lack the capacity for higher-order, role-based relational reasoning. We argue this distinction applies to all domains of cognition.

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