Hennessy, Richard G; (2002) Peri-traumatic verbal processing and the development of intrusions. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

A defining characteristic of post-traumatic stress disorder (PTSD) is the re- experiencing of distressing material in the form of memory intrusions. Dual Representation Theory (Brewin, Dalgleish & Joseph, 1996) suggests that the efficiency of peri-traumatic verbal processing (i.e. verbal processing during the traumatic event) is a key factor in the development of intrusions. This prediction was tested using a trauma analogue and a non-clinical sample. Sixty volunteers were exposed to a distressing film of the aftermath of road-traffic accidents and instructed to keep a diary of intrusions before returning for follow-up one week later. Verbal processing was manipulated across three experimental conditions, including: (1) Peri-traumatic verbal distraction via a concurrent backward counting task; (2) Peri-traumatic verbal enhancement via concurrent verbalisation in response to the film; and (3) No task control. In accordance with Dual Representation Theory, it was predicted that the verbal distraction task would compete for cognitive resources with verbally accessible memory (VAM), leading to more intrusions. Verbal enhancement was predicted to facilitate VAM encoding and lead to less intrusions. As predicted, the verbal distraction group reported significantly more intrusions than the control group and showed evidence of less conceptual processing of the meaning of the film. Contrary to predictions, the verbal enhancement group did not report less intrusions or show evidence of deeper conceptual processing of meaning. Further analysis indicated that across conditions verbal task performance was impaired during scenes of the film that gave rise to subsequent "most significant" intrusions. Theoretical and clinical implications of the study are discussed primarily in relation to Dual Representation Theory and Ehlers and Clark's (2000) cognitive model of PTSD.

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