Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2014-0063
Trends in Psychiatry and Psychotherapy
Review Article

The role of memory in posttraumatic stress disorder: implications for clinical practice

O papel da memória no transtorno de estresse pós-traumático: implicações para a prática clínica

Marcelo Montagner Rigoli; Gustavo Ramos Silva; Fernando Rainho de Oliveira; Giovanni Kuckartz Pergher; Christian Haag Kristensen

http://dx.doi.org/10.1590/2237-6089-2014-0063 Trends Psychiatry Psychother, vol.38, n3, p.119-127, 2016
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Abstract

Abstract Introduction: Posttraumatic stress disorder (PTSD) is a highly prevalent disorder with important social consequences. Several models have been developed with the aim of understanding the mechanisms underlying its symptoms. Intrusions are idiosyncratic symptoms that commonly take the form of involuntary recollection of images or flashbacks about the traumatic event. Objective: To review how memory is conceptualized in each of these models and the implications for clinical practice. Methods: A narrative review of the literature was conducted through analysis of the perspectives of memory in theoretical models of PTSD. Results: Two main perspectives were identified: 1) models in which specific mechanisms of memory for processing traumatic events are proposed, especially those based on clinical studies, and 2) models in which common mnemonic mechanisms are utilized to explain the phenomenon, primarily based on basic experimental research studies investigating memory. The different theories based on these approaches have led to distinct psychotherapy interventions. Conclusion: In order to clarify these discrepancies, future research should aim for the methodological rigor of experimental studies, while maintaining the ecological applicability of findings. Cognitive experimental psychopathology is therefore an area on which research funding should be focused. Such studies could elucidate the role of mnemonic aspects in PTSD and how they impact psychological treatments.

Keywords

Posttraumatic stress disorder, memory, experimental psychopathology, cognitive therapy

Resumo

Resumo Introdução: O transtorno de estresse pós-traumático (TEPT) é altamente prevalente e traz consequências sociais importantes. Diversos modelos foram desenvolvidos com o objetivo de compreender os mecanismos subjacentes aos seus sintomas. Intrusões constituem sintomas idiossincráticos, que regularmente tomam a forma de lembranças involuntárias de imagens ou flashbacks do evento traumático. Objetivo: Revisar como a memória é definida conceitualmente nos modelos teóricos propostos e as implicações para a prática clínica. Métodos: Uma revisão narrativa da literatura foi conduzida através da análise das perspectivas de memória em modelos teóricos de TEPT. Resultados: Duas perspectivas principais foram identificadas: 1) modelos com a proposição de mecanismos de memória específicos ao processamento de eventos traumáticos, especialmente apoiados em estudos clínicos, e 2) modelos em que mecanismos mnemônicos comuns são utilizados para explicar o fenômeno, primariamente baseados em estudos experimentais de base investigando memória. As diferentes teorias baseadas nessas perspectivas levaram a distintas abordagens psicoterapêuticas. Conclusões: Para clarificar essas discrepâncias, sugere-se que pesquisas futuras busquem maior rigor metodológico de estudos experimentais, mantendo a aplicabilidade ecológica dos achados. A psicopatologia cognitiva experimental é uma área na qual devem ser focados os financiamentos de pesquisa. Tais estudos podem elucidar o papel de aspectos mnemônicos no TEPT e como impactam tratamentos psicológicos.

Palavras-chave

Transtorno de estresse pós-traumático, memória, psicopatologia experimental, terapia cognitiva

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