Skip to main content
Original Article

Non-Idiographic Emotional Script-Driven Imagery in Posttraumatic Stress Disorder

Impact of Priming of Episodic Recall and Self-Referential Processing

Published Online:https://doi.org/10.1027/0044-3409/a000016

Abnormal emotional responses to standardized emotional stimuli in posttraumatic stress disorder (PTSD) implicate problems in emotional processing less obviously linked to traumatic experiences. However, the personal meaningfulness and association of standardized emotional stimuli with specific episodic memories in PTSD participants has not been investigated. This paper takes the position that emotional processing of standardized stimuli cannot be divorced from the personal meaning these stimuli are ascribed, such as via the priming of episodic memory. Women with PTSD reported greater priming of episodic memories within the context of emotional imagery of standardized scripts, and episodic recall predicted emotional responses to script-driven imagery. Furthermore, greater priming of episodic recall during imagery of fear-anxiety scripts was associated with less response within the ventral medial prefrontal cortex. Clinical, theoretical, and methodological issues are discussed.

References

  • American Psychiatric Association (APA) . (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. First citation in articleGoogle Scholar

  • Blake, D. D. , Weathers, F. W. , Nagy, L. M. , Kaloupek, D. G. , Gusman, F. D. , Charney, D. S. , Keane, T. M. (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8, 75–90. First citation in articleCrossrefGoogle Scholar

  • Bremner, J. D. , Vermetten, E. , Vythilingam, M. , Afzal, N. , Schmahl, C. , Elzinga, B. , Charney, D. S. (2004). Neural correlates of the classic color and emotional Stroop in women with abuse-related posttraumatic stress disorder. Biological Psychiatry, 55, 612–620. First citation in articleCrossrefGoogle Scholar

  • Brewin, C. R. , & Holmes, E. A. (2003). Psychological theories of posttraumatic stress disorder. Clinical Psychology Review, 23, 1041–1065. First citation in articleCrossrefGoogle Scholar

  • Bryant, R. A. , Felmingham, K. , Kemp, A. , Das, P. , Hughes, G. , Peduto, A. , Williams, L. M. (2008). Amygdala and ventral anterior cingulated activation predicts treatment response to cognitive behaviour therapy for posttraumatic stress disorder. Psychological Medicine, 38, 555–561. First citation in articleCrossrefGoogle Scholar

  • Cloitre, M. , Cohen, L. R. , Koenen, K. C. (2006). Treating survivors of childhood abuse: Psychotherapy for the interrupted life. New York, NY: Guilford Press. First citation in articleGoogle Scholar

  • Dalgleish, T. (2004). Cognitive approaches to posttraumatic stress disorder: The evolution of multi-representational theorizing. Psychological Bulletin, 130, 228–260. First citation in articleCrossrefGoogle Scholar

  • Ehlers, A. , Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research & Therapy, 38, 319–345. First citation in articleCrossrefGoogle Scholar

  • Etkin, A. , Wager, T. D. (2007). Functional neuroimaging of anxiety: A meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. American Journal of Psychiatry, 164, 1476–1488. First citation in articleCrossrefGoogle Scholar

  • First, M. B. , Gibbon, M. , Spitzer, R. L. , Williams, J. B. W. (1996). Structured clinical interview for DSM-IV axis I disorders – Research version (SCID-I, version 2.0, February, 1996, final version). New York, NY: Biometrics Research. First citation in articleGoogle Scholar

  • Frewen, P. A. , Dozois, D. J. A. , Neufeld, R. W. J. , Densmore, M. , Stevens, T. , & Lanius, R. A. (in press). Social emotions and emotional valence during imagery in women with PTSD: Affective and neural correlates. Psychological Trauma: Theory, Research, Practice & Policy. First citation in articleGoogle Scholar

  • Frewen, P. A. , & Lanius, R. A. (2006). Toward a psychobiology of posttraumatic self-dysregulation: Re-experiencing, hyperarousal, dissociation, and emotional numbing. Annals of the New York Academy of Sciences, 1071, 110–124. First citation in articleCrossrefGoogle Scholar

  • Gillihan, S. J. , & Farah, M. J. (2005). Is self special? A critical review of evidence from experimental psychology and cognitive neuroscience. Psychological Bulletin, 131, 76–97. First citation in articleCrossrefGoogle Scholar

  • Hopper, J. W. , Frewen, P. A. , van der Kolk, B. A. , Lanius, R. A. (2007). Dimensional analysis of responses to script-driven trauma imagery in PTSD: Neural correlates of re-experiencing, avoidance, and dissociation. Journal of Traumatic Stress, 20, 713–725. First citation in articleCrossrefGoogle Scholar

  • Lang, P. J. , Bradley, M. M. , Cuthbert, B. N. (1997). International affective picture system (IAPS): Technical manual and affective ratings. Gainesville, FL: NIMH Center for the Study of Emotion and Attention, University of Florida. First citation in articleGoogle Scholar

  • Lang, P. J. , Bradley, M. M. , Cuthbert, B. N. (2005). International affective picture system (IAPS): Technical report A-6. Gainesville, FL: University of Florida. First citation in articleGoogle Scholar

  • Lanius, R. A. , Williamson, P. C. , Hopper, J. , Densmore, M. , Boksman, K. , Gupta, M. A. , …, Menon, R. S. (2003). Recall of emotional states in posttraumatic stress disorder: A fMRI investigation. Biological Psychiatry, 53, 204–210. First citation in articleCrossrefGoogle Scholar

  • Legrand, D. , Ruby, P. (2009). What is self-specific? Theoretical investigation and critical review of neuroimaging results. Psychological Review, 116, 252–282. First citation in articleCrossrefGoogle Scholar

  • Lemogne, C. , le Bastard, G. , Mayberg, H. , Volle, E. , Bergouignan, L. , Lehéricy, S. , …, Fossati, P. (2009). In search of the depressive self: Extended medial prefrontal network during self-referential processing in major depression. Social Cognitive & Affective Neuroscience, 4, 305–312. First citation in articleCrossrefGoogle Scholar

  • Levine, B. (2004). Autobiographical memory and the self in time: Brain lesion effects, functional neuroanatomy, and lifespan development. Brain & Cognition, 55, 54–68. First citation in articleCrossrefGoogle Scholar

  • Liberzon, I. , Martis, B. (2006). Neuroimaging studies of emotional responses in PTSD. Annals of the New York Academy of Sciences, 1071, 87–109. First citation in articleCrossrefGoogle Scholar

  • Litz, B. T. (1992). Emotional numbing in combat-related post-traumatic stress disorder: A critical review and reformulation. Clinical Psychology Review, 12, 417–432. First citation in articleCrossrefGoogle Scholar

  • Litz, B. T. , Gray, M. J. (2002). Emotional numbing in posttraumatic stress disorder: Current and future research directions. Australian & New Zealand Journal of Psychiatry, 36, 198–204. First citation in articleCrossrefGoogle Scholar

  • McKinnon, M. C. , Svoboda, E. , Levine, B. (2007). The frontal lobes and autobiographical memory. In B. L. Miller, J. L. Cummings (Eds.), The human frontal lobes: Functions and disorders (2nd ed., pp. 227–248). New York, NY: Guilford Press. First citation in articleGoogle Scholar

  • McTeague, L. M. , Lang, P. J. , Laplante, M.-C. , Cuthbert, B. N. , Shumen, J. R. , Bradley, M. M. (2010). Aversive imagery in posttraumatic stress disorder: Trauma recurrence, comorbidity, and physiological reactivity. Biological Psychiatry, 67, 346–356. First citation in articleCrossrefGoogle Scholar

  • Moran, J. M. , Heatherton, T. F. , Kelley, W. M. (2009). Modulation of cortical midline structures by implicit and explicit self-relevance. Social Neuroscience, 4, 197–211. First citation in articleCrossrefGoogle Scholar

  • New, A. S. , Fan, J. , Murrough, J. W. , Liu, X. , Liebman, R. E. , Guise, K. G. , …, Charney, D. S. (2009). A functional magnetic resonance imaging study of deliberate emotion regulation in resilience and posttraumatic stress disorder. Biological Psychiatry, 66, 656–664. First citation in articleCrossrefGoogle Scholar

  • Northoff, G. (2007). Psychopathology and pathophysiology of the self in depression: Neuropsychiatric hypothesis. Journal of Affective Disorders, 104, 1–14. First citation in articleGoogle Scholar

  • Northoff, G. , Heinzel, A. , de Greck, M. , Bermpohl, F. , Dobrowolny, H. , Panksepp, J. (2006). Self-referential processing in our brain: A meta-analysis of imaging studies on the self. NeuroImage, 31, 440–457. First citation in articleCrossrefGoogle Scholar

  • Oatley, K. , Johnson-Laird, P. N. (1987). Towards a cognitive theory of emotions. Cognition & Emotion, 1, 29–50. First citation in articleCrossrefGoogle Scholar

  • Ochsner, K. N. , Knierim, K. , Ludlow, D. H. , Hanelin, J. , Ramachandran, T. , Glover, G. , Mackey, S. C. (2004). Reflecting upon feelings: An fMRI study of neural systems supporting the attribution of emotion to self and other. Journal of Cognitive Neuroscience, 16, 1746–1772. First citation in articleCrossrefGoogle Scholar

  • Ochsner, K. N. , Bunge, S. A. , Gross, J. J. , Gabrieli, J. D. E. (2002). Rethinking feelings: An fMRI study of the cognitive regulation of emotion. Journal of Cognitive Neuroscience, 14, 1215–1229. First citation in articleCrossrefGoogle Scholar

  • Phan, K. L. , Britton, J. C. , Taylor, S. F. , Fig, L. M. , Liberzon, I. (2006). Corticolimbic blood flow during nontraumatic emotional processing in posttraumatic stress disorder. Archives of General Psychiatry, 63, 184–192. First citation in articleCrossrefGoogle Scholar

  • Phan, K. L. , Taylor, S. F. , Welsh, R. C. , Ho, S.-H. , Britton, J. C. , Liberzon, I. (2004). Neural correlates of individual ratings of emotional salience: A trial-related fMRI study. NeuroImage, 21, 768–780. First citation in articleCrossrefGoogle Scholar

  • Protopopescu, X. , Pan, H. , Tuescher, O. , Cloitre, M. , Goldstein, M. , Engelien, W. , …, Stern, E. (2005). Differential time courses and specificity of amygdala activity in posttraumatic stress disorder subjects and normal control subjects. Biological Psychiatry, 57, 464–473. First citation in articleCrossrefGoogle Scholar

  • Rauch, S. L. , Whalen, P. J. , Shin, L. M. , McInerny, S. C. , Macklin, M. L. , Lasko, N. B. , …, Pitman, R. K. (2000). Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: A functional MRI study. Biological Psychiatry, 47, 769–776. First citation in articleCrossrefGoogle Scholar

  • Rosen, G. M. , Lilienfeld, S. O. (2008). Posttraumatic stress disorder: An empirical evaluation of core assumptions. Clinical Psychology, 28, 837–868. First citation in articleGoogle Scholar

  • Saxe, R. , Moran, J. M. , Scholz, J. , Gabrielli, J. (2006). Overlapping and non-overlapping brain regions for theory of mind and self-reflection in individual subjects. Social Cognitive and Affective Neuroscience, 1, 229–234. First citation in articleCrossrefGoogle Scholar

  • Schmitz, T. W. , & Johnson, S. C. (2007). Relevance to self: A brief review and framework of neural systems underlying appraisal. Neuroscience and Biobehavioral Reviews, 31, 585–596. First citation in articleCrossrefGoogle Scholar

  • Shin, L. M. , Whalen, P. J. , Pitman, R. K. , Bush, G. , Macklin, M. L. , Lasko, N. B. , …, Rauch, S. L. (2001). An fMRI study of anterior cingulate function in posttraumatic stress disorder. Biological Psychiatry, 50, 932–942. First citation in articleCrossrefGoogle Scholar

  • Shin, L. M. , Wright, C. L. , Cannistraro, P. A. , Wedig, M. M. , McMullin, K. , Martis, B. , …, Rauch, S. L. (2005). A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder. Archives of General Psychiatry, 62, 273–281. First citation in articleCrossrefGoogle Scholar

  • Svoboda, E. , McKinnon, M. C. , Levine, B. (2006). The functional neuroanatomy of autobiographical memory: A meta-analysis. Neuropsychologia, 44, 2189–2208. First citation in articleCrossrefGoogle Scholar

  • Williams, L. M. , Kemp, A. H. , Felmingham, K. L. , Barton, M. , Olivieri, G. , Peduto, A. S. , …, Bryant, R. A. (2006). Trauma modulates amygdala and medial prefrontal responses to consciously attended fear. NeuroImage, 29, 347–357. First citation in articleCrossrefGoogle Scholar