Effects of Peritraumatic Alcohol Intoxication on Intrusive Memories

描述（由申请人提供）：近五分之一的女性曾是强奸受害者（Black et al., 2011），约五分之二的强奸受害者出现创伤后应激障碍（PTSD）症状，包括侵入性记忆（Kilpatrick, Resnick, Ruggierio, Conoscenti, & McCauley, 2007）。侵入性记忆，包括创伤事件的生动、痛苦的想法或图像，是创伤后应激障碍的标志性症状（Foa, Steketee, & Rothbaum, 1989）。侵入性记忆和相关的创伤症状与自杀企图、共病精神健康诊断（Pietrzak, Goldstein, Southwick, & Grant, 2011）和身体健康问题（Pacella, Hruska, & Delahanty, 2013）的风险增加有关。性侵犯后侵入性记忆的高患病率和痛苦强调了了解这种侵入性记忆的病因的必要性。先前的研究已经检查了性侵犯后侵入发展的各种风险因素（例如，创伤的认知加工和记忆，创伤周围压力）。然而，尽管半数遭受性侵犯的女性当时受到酒精的影响（Abbey, Zawacki, Buck, Clinton, & mccauslan, 2004），很少有研究调查受害者酒精中毒在性侵犯后创伤症状发展中的作用。本研究通过检查创伤周围酒精中毒对社区女性样本暴露于类似创伤后侵入性记忆的影响来解决这一需求。利用酒精性近视模型（AMM; Steele & Josephs, 1990）和著名的创伤后应激障碍认知模型（Ehlers & Clark, 2000），本研究考察了创伤期酒精中毒对侵入性记忆的剂量依赖性影响，其介导因素包括酒精性近视、应激反应、认知加工方式和创伤记忆的紊乱。该研究采用了一种实验设计，包括以实验室为基础的酒精管理，一种被广泛接受的模拟创伤暴露范式（带有痛苦或“创伤”内容的电影），侵入性记忆的每日日记评估，以及关键构象（如酒精近视、应激反应）的行为测量。总的来说，酒精性近视预计会破坏认知加工和创伤记忆的形成，导致低水平醉酒时侵入性记忆的增加。然而，高水平醉酒时的应激反应抑制有望减少侵入性记忆。从这项研究中获得的知识将阐明酒精中毒在侵入性记忆发展中的作用，并有望强调旨在减少酒精相关受害者的预防和干预计划的重要性。

DESCRIPTION (provided by applicant): Nearly 1 in 5 women have been the victim of rape (Black et al., 2011), and about 2 in 5 rape victims develop symptoms of posttraumatic stress disorder (PTSD), including intrusive memories (Kilpatrick, Resnick, Ruggierio, Conoscenti, & McCauley, 2007). Intrusive memories, which include vivid, distressing thoughts or images of a traumatic event, are a hallmark symptom of PTSD (Foa, Steketee, & Rothbaum, 1989). Intrusive memories and related trauma symptoms are associated with an increased risk of suicide attempts, comorbid mental health diagnoses (Pietrzak, Goldstein, Southwick, & Grant, 2011), and physical health problems (Pacella, Hruska, & Delahanty, 2013). The high prevalence and suffering associated with intrusive memories following a sexual assault underscore the need to understand the etiology of such intrusions. Prior research has examined various risk factors for the development of intrusions following sexual assault (e.g., cognitive processing and memory for the trauma, peritraumatic stress). However, although half of all women who are sexually assaulted are under the influence of alcohol at the time (Abbey, Zawacki, Buck, Clinton, & McAuslan, 2004), little research has examined the role of victim alcohol intoxication in the development of post-assault trauma symptoms. The present study addresses this need by examining the effects of peritraumatic alcohol intoxication on intrusive memories following exposure to an analog trauma in a community sample of women. Drawing on the Alcohol Myopia Model (AMM; Steele & Josephs, 1990) and a prominent cognitive model of PTSD (Ehlers & Clark, 2000), the present investigation examines dose-dependent effects of peritraumatic alcohol intoxication on intrusive memories, as mediated by alcohol myopia, stress responses, cognitive processing style, and disorganization of trauma memories. The study utilizes an experimental design that includes lab-based alcohol administration, a well-accepted analog trauma exposure paradigm (a film with distressing or "traumatic" content), a daily diary assessment of intrusive memories, and behavioral measures of key constructs (e.g., alcohol myopia, stress response). Overall, alcohol myopia is expected to disrupt cognitive processing and formation of trauma memories, resulting in increased intrusive memories for low levels of intoxication. However, stress-response dampening at high levels of intoxication is expected to reduce intrusive memories. Knowledge gained from this study will clarify the role of alcohol intoxication in the development of intrusive memories and is expected to highlight the importance of prevention and intervention programs aimed at reducing alcohol-involved victimization.