Prospective stability of memory for peritraumatic dissociation and anxiety: Replication and extension examining PTSD treatment modality and response.

Objective: Retrospective memory for peritraumatic reactions occurring during or immediately after trauma exposure may decrease in intensity for some over treatment. This may be due to psychotherapy-specific memory processes, such as repeated accessing of the trauma memory. Additionally, it may be that recovery drives changes in memory for these experiences. Critical to examining these hypotheses is an effective control treatment that reduces symptoms but does not directly involve repeated retrieval of the trauma memory, such as pharmacotherapy.

Method: In a sample of 200 individuals with posttraumatic stress disorder, retrospective memory for dissociation and anxiety occurring around the index traumatic event (Peritraumatic Dissociative Experiences Questionnaire, Marmar et al., 1997; Stanford Acute Stress Reaction Questionnaire, Cardeña et al., 2000) was assessed before and after treatment in a randomized clinical trial (NCT00127673) comparing prolonged exposure and sertraline.

Results: Participants reported that their memory for dissociation and anxiety at the time of the trauma was less intense at posttreatment (d = 0.26-0.64). There was no difference between prolonged exposure and sertraline on these memory indices. However, treatment responders, using a clinically meaningful change cutoff score, remembered their reactions at the time of the trauma as less dissociative (d = 0.66) and less anxious (d = 1.19) at posttreatment than nonresponders.

Conclusions: Retrospective memory for the intensity of reactions experienced at the time of the traumatic event decreased from pre- to posttreatment, with effects most pronounced for those who made clinically meaningful gains in treatment. Inclusion of a nonpsychotherapy intervention control argues that recovery processes may explain these shifts and point to potential mood-dependent memory effects. (PsycInfo Database Record (c) 2024 APA, all rights reserved).