A Model of Autobiographical Memory & Its Changes in PTSD

描述（由申请人提供）：我们制定并测试了创伤后应激障碍（PTSD）的理论，该理论仅基于在认知，人格和情感的科学研究中有坚实支持的机制。该理论结合了实验和个体差异研究的发现，做出了与现有PTSD理论相矛盾的预测，但与现有数据一致。这是第一个将创伤事件、人格和记忆过程的严重程度结合起来的理论。此外，它通过为各种措施分配数值权重来定量预测临床结果。本文提出了两项主要研究，均采用结构方程模型。首先，200名成年人将接受测试，他们的症状严重程度各不相同。其中，至少有50人符合当前PTSD的标准临床诊断纳入标准，50人符合终生PTSD的标准排除标准，因此，除了相关分析外，还可以直接比较PTSD文献中使用的原型组。为了提供预测变量，参与者将完成情绪和性格的标准化测试。他们将回忆并记录他们最痛苦或最紧张的事件的叙述版本，并根据连贯性和事件严重程度进行评分。他们还会回忆三个最积极和最重要的事件，并想象未来发生在他们身上的三个创伤情景。想象的未来事件将探究参与者如何看待和应对创伤性事件。对于他们的每一个记忆和想象的事件，参与者将提供情绪强度和效价、感官信息的生动性、叙述的连贯性和事件的再现程度的测量。他们还将对两周内浮现在脑海中的非自愿的、通常是侵入性的记忆进行评分，并将他们的回答记录在个人数据助理上。这种在线技术是由我们小组开发的，它在PTSD人群中仍然是独一无二的。它提供了侵入性记忆的最精确测量，这是创伤后应激障碍的一个关键症状。获得的丰富数据集使我们能够理清相互竞争的现有假设，更好地理解导致和维持创伤后应激障碍的机制。第二项研究使用了相同的理论和定量技术，但利用了一项持续20年的纵向研究。与第一次研究相比，它的测试数量更少，但与第一次研究相似，并抽样了数千名大约60岁的成年人。它包括当前PTSD症状严重程度的测试，情绪和性格测试，以及健康数据，对当前PTSD症状进行真正的前瞻性研究，正如纵向获得的测量结果所预测的那样。将进行额外的测试和实验，以检验具体的支持性假设。特别地，我们将研究那些有或没有临床诊断为PTSD的参与者对创伤性的、非常积极的和重要的事件的记忆叙述的一致性。

DESCRIPTION (provided by applicant): We formulate and test a theory of posttraumatic stress disorder (PTSD) based only on mechanisms that have solid support in scientific studies of cognition, personality, and emotion. The theory combines findings from experimental and individual differences research to make predictions that often contradict existing theories of PTSD, but that agree with the existing data. It is the first theory to combine measures of the severity of traumatic events, personality, and memory processes. Moreover, it predicts quantitatively clinical outcomes by assigning numerical weights to the various measures. Two main studies are proposed, which use structural equation models. In the first, 200 adults will be tested, who vary in symptom severity. Of these, at least 50 will meet standard clinical diagnostic inclusion criteria for current PTSD and 50 will meet standard exclusion criteria for lifetime PTSD so that, in addition to the correlational analyses, direct comparisons can be made between the prototypical groups used in the PTSD literature. To provide predictor variables, the participants will complete standardized tests of mood and personality. They will recall and record a narrative version of their most traumatic or stressful events, which will be scored for coherence and event severity. They will also recall their three most positive and three most important events and imagine that three traumatic scenarios occur to them in the future. The imagined future events will probe how the participants view and react to traumatic events in general. For each of their memories and the imagined events, participants will provide measures of emotional intensity and valence, vividness of sensory information, narrative coherence, and degree of reliving of the event. They will also provide ratings of involuntary, often intrusive, memories made as they come to mind for two weeks, recording their responses on personal data assistants. This online technique was developed by our group and its use is still unique to it in PTSD populations. It provides the most accurate measure of intrusive memories, a key symptom of PTSD. The rich data set obtained allows us to disentangle competing existing hypotheses and better understand the mechanisms that lead to and maintain PTSD. The second study uses the same theory and quantitative techniques, but takes advantage of an ongoing longitudinal study in its 20th year. It includes fewer, but similar, tests to the first study and a sample of several thousand adults approximately 60 years old. It includes tests of current PTSD symptom severity, mood and personality tests, as well as health data, to do a truly prospective study of current PTSD symptoms as predicted by measures obtained longitudinally. Additional tests and experiments will be conducted to test specific supporting hypotheses. In particular, we will examine the coherence of narrative of memories of traumatic, very positive, and important events in participants who have or do not have a clinical diagnosis of PTSD. PUBLIC HEALTH RELEVANCE: Based on measures of the severity of a traumatic event, the personality of the person experiencing the event, and the properties of the memories that the person has of the event and of other non-traumatic events, we attempt to predict which people will develop posttraumatic stress disorder (PTSD) and how severe their symptoms will be. We do this by trying to understand autobiographical memory for emotional, stressful events. Our quantitative theory, if successful, would help identify risk factors for PTSD and should suggest which properties of traumatic memories therapy should attempt to change.