Publications internationales Unwanted memories of assault: what intrusion characteristics are associated with PTSD?

Unwanted memories of assault: what intrusion characteristics are associated with PTSD?

T. Michael, A. Ehlers, S.L. Halligan and D.M. Clark

Revue : Behaviour Research and Therapy

Received 30 January 2004; revised 20 April 2004; accepted 30 April 2004. Available online 24 July 2004.


Intrusive memories are common in the immediate aftermath of traumatic events, but neither their presence or frequency are good predictors of the persistence of posttraumatic stress disorder (PTSD). Two studies of assault survivors, a cross-sectional study (N=81) and a 6-month prospective longitudinal study (N=73), explored whether characteristics of the intrusive memories improve the prediction. Intrusion characteristics were assessed with an Intrusion Interview and an Intrusion Provocation Task. The distress caused by the intrusions, their ?here and now? quality, and their lack of a context predicted PTSD severity. The presence of intrusive memories only explained 9% of the variance of PTSD severity at 6 months after assault. Among survivors with intrusions, intrusion frequency only explained 8% of the variance of PTSD symptom severity at 6 months. Nowness, distress and lack of context explained an additional 43% of the variance. These intrusion characteristics also predicted PTSD severity at 6 months over and above what could be predicted from PTSD diagnostic status at initial assessment. Further predictors of PTSD severity were rumination about the intrusive memories, and the ease and persistence with which intrusive memories could be triggered by photographs depicting assaults. The results have implications for the early identification of trauma survivors at risk of chronic PTSD.

Keywords: Posttraumatic stress disorder; Trauma memories; Intrusions; Predictors of PTSD; Rumination; Screening

Behaviour Research and Therapy - Volume 43, Issue 5, Pages 613-628 (May 2005)

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