A Model of Autobiographical Memory & Its Changes in PTSD

描述（由申请人提供）：我们制定和测试创伤后应激障碍（PTSD）的理论，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结果，做出的预测往往与现有的PTSD理论相矛盾，但与现有的数据相一致。这是第一个将创伤事件、人格和记忆过程的严重程度的测量联合收割机结合起来的理论。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。提出了两个主要的研究，其中使用结构方程模型。首先，将对200名症状严重程度不同的成年人进行测试。其中，至少有50人将符合标准的临床诊断纳入标准，目前的创伤后应激障碍和50人将符合标准的排除标准，终身创伤后应激障碍，使，除了相关性分析，可以直接比较的原型组中使用的创伤后应激障碍的文献。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述版本，并根据连贯性和事件严重性进行评分。他们还将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场景。想象的未来事件将探索参与者如何看待和反应创伤事件。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，叙事连贯性和事件的重温程度的测量。他们还将对两周内出现在脑海中的非自愿记忆（通常是侵入性记忆）进行评级，并将他们的反应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人群中的使用仍然是独一无二的。它提供了最准确的侵入性记忆的测量方法，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解开现有的相互竞争的假设，更好地理解导致和维持创伤后应激障碍的机制。第二项研究使用相同的理论和定量技术，但利用了正在进行的纵向研究在其20年。它包括了与第一项研究类似的较少的测试，以及数千名60岁左右的成年人的样本。它包括当前PTSD症状严重程度的测试，情绪和个性测试，以及健康数据，以进行真正的前瞻性研究，通过纵向获得的措施预测当前PTSD症状。将进行额外的测试和实验，以测试特定的支持假设。特别是，我们将研究创伤性记忆的连贯性，非常积极的，重要的事件在参与者中有或没有PTSD的临床诊断。 公共卫生相关性：基于创伤性事件的严重程度，经历该事件的人的个性，以及该人对该事件和其他非创伤性事件的记忆的性质，我们试图预测哪些人会患上创伤后应激障碍（PTSD）以及他们的症状会有多严重。我们通过试图理解自传体记忆中的情感，压力事件来做到这一点。我们的定量理论，如果成功的话，将有助于识别PTSD的风险因素，并应该建议创伤记忆治疗的哪些属性应该尝试改变。

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.