Learning and Consolidation of Verbal Declarative Memory in Patients with Posttraumatic Stress Disorder
Abstract
Impairments in declarative memory have been reported in posttraumatic stress disorder (PTSD). Fragmentation of explicit trauma-related memory has been assumed to impede the formation of a coherent memorization of the traumatic event and the integration into autobiographic memory. Together with a strong non-declarative memory that connects trauma reminders with a fear response the impairment in declarative memory is thought to be involved in the maintenance of PTSD symptoms. Fourteen PTSD patients, 14 traumatized subjects without PTSD, and 13 non-traumatized healthy controls (HC) were tested with the California Verbal Learning Test (CVLT) to assess verbal declarative memory. PTSD symptoms were assessed with the Clinician Administered PTSD Scale and depression with the Center of Epidemiological Studies Depression Scale. Several indices of the CVLT pointed to an impairment in declarative memory performance in PTSD, but not in traumatized persons without PTSD or HC. No group differences were observed if recall of memory after a time delay was set in relation to initial learning performance. In the PTSD group verbal memory performance correlated significantly with hyperarousal symptoms, after concentration difficulties were accounted for. The present study confirmed previous reports of declarative verbal memory deficits in PTSD. Extending previous results, we propose that learning rather than memory consolidation is impaired in PTSD patients. Furthermore, arousal symptoms may interfere with successful memory formation in PTSD.
References
1994). Diagnostic and statistical manual of mental disorders (4th ed., DSM-IV). Washington DC: American Psychiatric Association.
. (1995). The development of a Clinician-Administered PTSD Scale. Journal of Traumatic Stress, 8, 75–90.
(2003). MRI and PET study of deficits in hippocampal structure and function in women with childhood sexual abuse and posttraumatic stress disorder. The American Journal of Psychiatry, 160, 924–932.
(1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103, 670–686.
(2007). Memory for emotionally neutral information in posttraumatic stress disorder: A meta-analytic investigation. Journal of Abnormal Psychology, 116, 448–463.
(2001). Cognitive functioning and the early development of PTSD. Journal of Traumatic Stress, 14, 791–797.
(2007). Emotion and resilience: A multilevel investigation of hemispheric electroencephalogram asymmetry and emotion regulation in maltreated and nonmaltreated children. Development and Psychopathology, 19, 811–840.
(1987). California verbal learning test (CVLT) research edition – Adult version. New York: Psychological Corporation.
(2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345.
(1997). User’s guide for the structured clinical interview for DSM-IV axis II personality disorders (SCID-II). Washington DC: American Psychiatric Press.
(1997). User’s guide for the structured clinical interview for DSM-IV axis I disorders (SCID-I)-clinical version. Washington DC: American Psychiatric Press.
(1997). Strukturiertes Klinisches Interview für DSM-IV. Achse II: Persönlichkeitsstörungen.
(User's guide for the structured clinical interview for DSM-IV axis II personality disorders (SCID-II) Göttingen: Hogrefe.2006). Memory performance in older trauma survivors: Implications for the longitudinal course of PTSD. Annals of the New York Academy of Sciences, 1071, 54–66.
(1994). Hippocampal formation size in normal human aging: A correlate of delayed secondary memory performance. Learning & Memory, 1, 45–54.
(1998). Autobiographical memory in acute stress disorder. Journal of Consulting and Clinical Psychology, 66, 500–506.
(1993). Allgemeine Depressions Skala (ADS)
([General depression scale] . Weinheim, Germany: Beltz Test.2009). The organization of autobiographical and nonautobiographical memory in posttraumatic stress disorder (PTSD). Journal of Abnormal Psychology, 118, 288–298.
(2008). Consistent impaired verbal memory in PTSD: A meta-analysis. Journal of Affective Disorders, 111, 74–82.
(2009). Verbal learning and memory impairments in posttraumatic stress disorder: The role of encoding strategies. Psychiatry Research, 165, 68–77.
(2008). Memory impairments in posttraumatic stress disorder are related to depression. Journal of Anxiety Disorders, 22, 464–474.
(2007). The organisation and content of trauma memories in survivors of road traffic accidents. Behaviour Research and Therapy, 45, 151–162.
(2004). The nature of traumatic memories: A 4-T FMRI functional connectivity analysis. The American Journal of Psychiatry, 161, 36–44.
(2005). Mehrfachwahl-Wortschatz-Intelligenztest MWT-B (5th ed.).
([Multiple choice vocabulary test MWT] . Balingen, Germany: Spitta Verlag GmbH.2003). Amnesia, flashbacks, nightmares, and dissociation in aging concentration camp survivors. Behaviour Research and Therapy, 41, 351–360.
(1999). A hot/cool-system analysis of delay of gratification: Dynamics of willpower. Psychological Review, 106, 3–19.
(2008). CVLT – California verbal learning test – Deutsche adaptation. Frankfurt: Pearson.
(1986). Mental representations: A dual coding approach. New York: Oxford University Press.
(2008). Changes in brain electrical activity after cognitive behavioral therapy for posttraumatic stress disorder in patients injured in motor vehicle accidents. Psychosomatic Medicine, 70, 13–19.
(1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
(2007). Stress and memory: Behavioral effects and neurobiological mechanisms. Neural Plasticity, 2007, 78970.
(2006). Grundintelligenztest Skala 2 – Revision – (CFT 20-R)
([Culture fair intelligence test] . Göttingen: Hogrefe.2010). Reliability, validity and factor structure of the Clinician-Administered PTSD Scale in a heterogeneous trauma sample. Submitted for publication.
(2006). Retrieval and emotional processing of traumatic memories in posttraumatic stress disorder: Peripheral and central correlates. Neuropsychologia, 44, 1683–1696.
(1997). Strukturiertes Klinisches Interview für DSM-IV. Achse I: Psychische Störungen
([User's guide for the structured clinical interview for DSM-IV axis I disorders (SCID-I) – clinical version] . Göttingen: Hogrefe.