(PS4-B43) Intervening on Peritraumatic Intrusive Memory Trajectories with Contextual Processing: A Trauma Analogue Study

Background: Intrusive memories are a cardinal symptom of posttraumatic stress disorder (PTSD), and thus may be a potent target for early intervention to prevent trauma-related sequelae. Leveraging the cognitive literature on retrieval as a powerful memory modifier, the retrieval-based feedback loop theory of intrusive memories (Marks et al., 2018) suggests that early retrieval of some aspects of a memory trace increases the availability of those aspects of the memory and subsequently suppresses other aspects of the memory. Early retrieval of adaptive pieces of the memory trace may facilitate a decrease in intrusive memories over time.  Critically, increasing contextual processing of memories may serve to limit memory generalizability and subsequent availability to being cued (Besnard & Sahay, 2016). We hypothesized that forced retrieval of contextual details of a trauma analogue film would result in less generalizable memories and ultimately fewer intrusive memories over a multiple day follow-up period.

Method: Participants (N = 87) were undergraduate college students (59.8% women; age M = 19.06, SD = 2.04). The sample was 70.1% Asian-identifying, 16.1% white or Caucasian, 4.6% Middle Eastern or North African, and 8.9% identified as another race/ethnicity, including American Indian/Alaska Native, Black/African American, and Latinx/Hispanic, or multiracial.

Participants viewed a distressing film depicting several bullies sexually assaulting a teenage boy at school, as well as the events leading up to and following the assault. Over the rest of the day, participants were cued via text message with either (a) context-related reminders, (b) central-gist-related reminders, or (c) film-independent reminders of study procedures.  Participants completed self-report questionnaires at baseline pertaining to depressive symptoms, generalized anxiety symptoms, and empathy. Key dependent variables were the number of intrusive memories experienced as well as the intensity and vividness of the memories for four days via an online daily diary.  

Results: At Day 1, higher empathy was initially associated with higher frequency of intrusions (r = .31, p = .004), intrusion distress (r = .52, p < .001) and intrusion vividness (r = .50, p < .001).  Similarly, being a woman was associated with higher initial intrusions (r = .28, p = .01) and intrusion distress (r = .22, p = .045).  By Day 4, only baseline depression was associated with higher intrusion distress, at a trend level (r = .21, p = .055), and intrusion vividness (r = .22, p = .045). Additional analyses will explore the differential role of context and gist reminders on intrusive memories over time.

Implications: The factors that predict initial intrusive memories, like empathy and gender, may differ from the factors associated with the persistence of these memories over time, such as  initial depressive symptoms. Identifying which variables are associated with the continued presence of intrusive memories over time is key to pinpointing individuals who would benefit from early intervention from those whose symptoms are likely to remit on their own (Galatzer-Levy et al., 2013).