A Model of Autobiographical Memory & Its Changes in PTSD

描述(由申请者提供)：我们制定和测试创伤后应激障碍(PTSD)理论，仅基于在认知、人格和情绪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结果，做出了经常与现有的创伤后应激障碍理论相矛盾的预测，但与现有的数据相一致。这是第一个将创伤事件的严重程度、个性和记忆过程的测量结合在一起的理论。此外，它还通过为各种测量分配数字权重来定量预测临床结果。提出了利用结构方程模型进行的两个主要研究。在第一个阶段，200名成年人将接受测试，他们的症状严重程度各不相同。在这些患者中，至少有50人将符合当前创伤后应激障碍的标准临床诊断纳入标准，50人将符合终生创伤后应激障碍的标准排除标准，因此，除了相关分析外，还可以在创伤后应激障碍文献中使用的典型群体之间进行直接比较。为了提供预测变量，参与者将完成情绪和个性的标准化测试。他们将回忆并记录他们最具创伤或压力的事件的叙事版本，并根据连贯性和事件严重性进行评分。他们还会回忆起他们最积极的三件事和三件最重要的事，并想象未来会发生三件令人痛苦的事情。想象中的未来事件将探索参与者如何看待和应对一般的创伤性事件。对于他们的每个记忆和想象的事件，参与者将提供情绪强度和效价、感官信息的生动程度、叙述连贯性和事件的重温程度的测量。他们还将在两周内对非自愿的、通常是侵入性的记忆进行评级，并将他们的反应记录在个人数据助理上。这项在线技术是由我们团队开发的，它在创伤后应激障碍人群中的使用仍然是独一无二的。它提供了对侵入性记忆的最准确测量，这是创伤后应激障碍的关键症状。获得的丰富数据集使我们能够理清相互竞争的现有假说，并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量化技术，但利用了20年来正在进行的纵向研究。它包括与第一项研究相似但较少的测试，以及数千名大约60岁的成年人的样本。它包括对当前创伤后应激障碍症状严重程度的测试、情绪和人格测试以及健康数据，以根据纵向获得的测量结果对当前创伤后应激障碍症状进行真正的前瞻性研究。还将进行额外的测试和实验，以检验具体的支持假说。特别是，我们将检查有或没有临床诊断为创伤后应激障碍的参与者对创伤性、非常积极和重要事件的记忆叙述的连贯性。

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.