Emotional working memory capacity in posttraumatic stress disorder (PTSD) Susanne Schweizer, Tim Dalgleish* Behaviour Research and Therapy Impact Factor: 2.957

Behaviour Research and Therapy The focus is on the following: theoretical and experimental analyses of psychopathological processes with direct implications for prevention and treatment……

Outline  Abstract  Introduction  Methods  Results  Discussion

Abstract  WMC 與 PTSD 、 depressive 、 anxiety disorders  eWMC 的操弄  運用在臨床治療的成效  未來可以發展的方向

Introduction

影響 PTSD 患者的因素  Emotionally-laden thoughts  Intrusive thought

“Hot” and “Cold” psychology Heath A. Demaree  People differ with regard to how well they can control their emotions, and one factor that predicts it is non-emotional in nature – it is a ‘cold’ cognitive construct  “Hot” psychology emotional psychology  Working memory capacity 保有短暫訊息的能力

WMC (working memory capacity) 的重要性  Define  對於 PTSD 的影響 ?  For example, a woman suffering from posttraumatic stress who…………  如何操弄 ?  WMC  eWMC  Regulate expressive and experiential aspects of emotion.

選用有長期 PTSD 病史的受試者 ?  Show substantive and significant biases on a wide range of cognitive measures indexing difficulties in processing trauma- related material  problem with proactive interference  Maladaptive intrusivetrauma-related appraisals  Risk of PTSD reactivation

Central study hypothesis  Trauma survivors with a lifetime history of PTSD would show impaired WMC on our novel emotional reading span task when the operation component (the sentences) was PTSD- related, compared with a control sample of trauma survivors who had never had PTSD, and relative to their performance with neutral control sentences as the operation component.

Methods

 Participants (aged 17 to 65 years) (PTSD LT; n ＝ 25) and （ PTSD C; n ＝ 14 ） (Controls; n ＝ 21)  Measures The Posttraumatic Cognitions Inventory (PTCI; Foa et al.,1999) The emotional working memory capacity (eWMC) task. EX.“I often carpet feel like a meaningless object not a person”

Emotional working memory capacity task trauma-related EX. The trauma happened to me because of the sort of person I am emotionally-neutral EX. In public libraries there are many different books that can be borrowed Sentence: from PTCI Trials: 8 in each condition Trial size: 4 、 5 、 6 、 7 neutral-valance word Irrelevant word: 11 sentences in each condition

Group(sentence)trailsTrail sizewords dysfunctional beliefs8 4、5、6、74、5、6、7 44 sentence- Word pairing emotionally-neutral facts 8 4、5、6、74、5、6、7 44 sentence- Word pairing

Words (neutral ) Medical Research Council Psycholinguistics Database length (4 to 6 letters) number of syllables (one) familiarity (550 to 700) Imageability (450 to 600) Did not relate to the sentence they were paired with.

Pilot study Healthy community volunteers (n = 20) sentences: size 4 - Mdifference=.08, SD=.17,t=2.16, P=.04; size 5 - Mdifference=.08, SD=.19, t=1.97; p=.06; size 6 - Mdifference=.07, SD=.16, t=1.95; P=.07; size 7 - Mdifference=0, SD=.12; t < 1.

Procedure informed consent eWMC task (trauma-related ) National Adult Reading Test eWMC task (neutral) (1)Beck Depression Inventory-II (2) Impact of Event Scale (3) Spielberger State-Trait Anxiety Inventory (4) SCID End

Results

Participant characteristics

 PTSDLT group showed impaired WMC in the context of trauma-related sentences, t(44) ＝ 2.66, P ＝.005, Cohen’s d ＝.80, but not significantly in the context of neutral sentences, t(44)=1.30,P=.13, Cohen’s d=.39,  Sentence Type (trauma vs. neutral) by Group (PTSDLT vs. Controls) interaction between these two effects, F(1,44) =4.15, P=.048,

Emotional working memory capacity (eWMC)

Discussion

 eWMC task : History of PTSD ＝ Current PTSD< Trauma-exposed controls Trauma survivors who, at any time, have struggled with PTSD suffer from significantly greater WMC impairments in emotional contexts compared with those survivors who have never suffered from PTSD and relative to non-significant group differences in performance in a valence-neutral context.

Clinical implications  Training program : CBM  Regulate emotion  Using images rather than sentences

Potential study limitations  Refine components of the experimental sentences  clarify is whether the effects are confined to mid- sized trials as the exploratory analyses indicate  Healthy participants for WMC to be greater in the face of trauma-related sentences, relative to neutral sentences  Did not assess depression and anxiety diagnostically sample

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