Does disconfirmatory evidence shape safety-and danger-related beliefs of trauma-exposed individuals?

Recent accounts of predictive processing in posttraumatic stress disorder (PTSD) suggest that trauma-exposed individuals struggle to update trauma-related hypotheses predicting danger, which may be involved in the etiology and maintenance of this disorder. Initial research supports this account, documenting an association between trauma-exposure, impaired expectation updating, and PTSD symptoms. Yet, no study to date has examined biased belief updating in PTSD using a scenario-based approach.Objective: Here, we examined the predictive processing account among trauma-exposed and non-trauma-exposed individuals using a modified Trauma-Related version of the Bias Against Disconfirmatory Evidence task.Method: The task presents both danger-and safety-related scenarios highly relevant for trauma-exposed individuals. For each scenario, participants viewed several explanations and rated their plausibility. Their ability to update their initial interpretation following new-contradictory information was assessed.Results: Preregistered analyses did not reveal any significant findings. Based on indications that our sample may not have been sufficiently powered, we conducted exploratory analyses in an extended sample of participants. These analyses yielded a significant association between reduced belief updating and PTSD symptoms which was evident for disconfirming both safety and danger scenarios. However, the effect sizes we found were in the small-to-medium range.Conclusion: Although preliminary, our current findings support initial evidence that individuals with higher PTSD symptoms show a higher resistance to update their beliefs upon new disconfirmatory evidence. Our results should be interpreted cautiously in light of the extended sample and the limitations of the current study.

We developed a modified version of the Bias Against Disconfirmatory Evidence task.We found significant associations between PTSD symptoms and belief updating.The association was evident for disconfirming both safety and danger scenarios.

Generation climate crisis, COVID-19, and Russia-Ukraine-War: global crises and mental health in adolescents.

Climate change, COVID-19, and the Russia-Ukraine War are some of the great challenges of our time. These global crises affect young people in a particularly vulnerable phase of their lives. The current study aimed to assess the impact of these crises on mental health (depression, anxiety, and health-related quality of life) in secondary school students in Germany. Furthermore, we assessed known predictors of mental health, such as socio-economic factors, individual life stressors, and resilience factors (self-efficacy, expressive flexibility) as covariates. In our sample of 3998 pupils, pandemic- and climate-related distress were linked to greater depression and anxiety and reduced health-related quality of life. War-related distress was associated with greater anxiety. Critically, these associations remained significant after controlling for all covariates, supporting the incremental predictive value of the crises measures. The study reveals a significant impact of the crises on the mental health of the current generation of adolescents. As such it suggests that mental health policies should include interventions that help youth to cope with the stress caused by the crises.

Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints.

Resilience can be viewed as trajectory of stable good mental health or the quick recovery of mental health during or after stressor exposure. Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health. A problem of resilience research is the large number of conceptually overlapping RFs complicating their understanding. The current study sheds light on the interrelations of RFs in the face of the COVID-19 pandemic as a use case for major disruptions. The non-preregistered prospective study assessed a sample of 1275 German-speaking people from February 2020 to March 2021 at seven timepoints. We measured coping, hardiness, control beliefs, optimism, self-efficacy, sense of coherence (SOC), sense of mastery, social support and dispositional resilience as RFs in February 2020, and mental health (i.e., psychopathological symptoms, COVID-19-related rumination, stress-related growth) at all timepoints. Analyses used partial correlation network models and latent growth mixture modeling (LGMM). Pre-pandemic RFs were strongly interrelated, with SOC being the most central node. The strongest associations emerged between coping using emotional support and social support, SOC and sense of mastery, and dispositional resilience and self-efficacy. SOC and active coping were negatively linked. When we examined RFs as predictors of mental health trajectories, SOC was the strongest predictor of psychopathological symptoms and rumination, while trajectories of stress-related growth were predicted by optimism. Subsequent network analyses, including individual intercepts and slopes from LGMM, showed that RFs had small to moderate associations with intercepts but were unrelated to slopes. Our findings provide evidence for SOC playing an important role in mental distress and suggest further examining SOC's incremental validity. However, our results also propose that RFs might be more important for stable levels of mental health than for adaptation processes over time. The differential associations for negative and positive outcomes support the use of multidimensional outcomes in resilience research.

To sleep or not to sleep, that is the question: A systematic review and meta-analysis on the effect of post-trauma sleep on intrusive memories of analog trauma.

Distressing intrusive memories of a traumatic event are one of the hallmark symptoms of posttraumatic stress disorder. Thus, it is crucial to identify early interventions that prevent the occurrence of intrusive memories. Both, sleep and sleep deprivation have been discussed as such interventions, yet previous studies yielded contradicting effects. Our systematic review aims at evaluating existing evidence by means of traditional and individual participant data (IPD) meta-analyses to overcome power issues of sleep research. Until May 16th, 2022, six databases were searched for experimental analog studies examining the effect of post-trauma sleep versus wakefulness on intrusive memories. Nine studies were included in our traditional meta-analysis (8 in the IPD meta-analysis). Our analysis provided evidence for a small effect favoring sleep over wakefulness, log-ROM = 0.25, p < .001, suggesting that sleep is associated with a lower number of intrusions but unrelated to the occurrence of any versus no intrusions. We found no evidence for an effect of sleep on intrusion distress. Heterogeneity was low and certainty of evidence for our primary analysis was moderate. Our findings suggest that post-trauma sleep has the potential to be protective by reducing intrusion frequency. More research is needed to determine the impact following real-world trauma and the potential clinical significance.

Cognitive flexibility moderates the efficacy of a visuospatial intervention following exposure to analog trauma.

BACKGROUND AND OBJECTIVES: Intrusive memories are the hallmark feature of Post-Traumatic-Stress-Disorder (PTSD). Recent studies show that a visuospatial intervention after viewing traumatic films reduces intrusive memories in healthy individuals. However, many individuals still exhibit high levels of symptoms following such an intervention, warranting continued investigation into specific characteristics moderating intervention effect. One such candidate is cognitive-flexibility, defined as the ability to update behavior according to contextual demands. The present study examined the interactive effect of cognitive-flexibility and a visuospatial intervention on intrusive memories, predicting that higher flexibility would be associated with stronger intervention effects. METHODS: Sixty participants (Mage = 29.07, SD = 4.23) completed a performance-based paradigm evaluating cognitive-flexibility, watched traumatic films, and were allocated to either an intervention or a no-task control group. Intrusions were assessed by means of laboratory and ambulatory assessment, and the intrusion subscale of the Impact-of-Events-Scale-Revised (IES-R). RESULTS: Participants in the intervention group experienced fewer laboratory intrusions than the control group. However, this effect was moderated by cognitive-flexibility: Whereas individuals with below-average cognitive-flexibility did not benefit from the intervention, it was significantly beneficial for individuals with average and above-average cognitive-flexibility. No group differences emerged in the number of ambulatory intrusions or IES-R scores. However, cognitive-flexibility was negatively correlated with IES-R scores across both groups. LIMITATIONS: The analog design may limit the extent of generalization to real-world traumatic events. CONCLUSIONS: These results point to a potentially beneficial effect of cognitive-flexibility on intrusion development, particularly in the context of visuospatial interventions.

The relationship between sense of coherence and mental health problems from childhood to young adulthood: A meta-analysis.

BACKGROUND: Sense of coherence (SOC) as the key component of the salutogenesis framework is negatively correlated with mental health problems in adults but also in children and adolescents. Since SOC is conceptualized to develop and stabilize from childhood to young adulthood, these life phases are of critical importance for the salutogenesis concept. Individual studies examining SOC's link with mental health at younger ages yielded heterogeneous effect size estimates. Thus, the present meta-analysis is the first to quantify the current state of evidence on the association between SOC and mental health problems. METHODS: The random-effects multi-level meta-analysis followed PRISMA guidelines and was based on 57 studies (70 samples) comprising 41,013 participants. Weighted mean age of participants was 15.46 years and 50.4 % were female. RESULTS: The mean correlation (r) between SOC and overall mental health problems was M(r) = -0.46, 95 % CI [-0.53, -0.39]. However, there was substantial heterogeneity between studies, while differences between symptom types were smaller. Subsequent moderator analyses showed that higher sample age was associated with more negative relationships and higher internal consistencies of SOC measures. Moreover, internalizing symptoms, depressive symptoms, and feelings of loneliness showed a stronger negative association with SOC than psychosomatic symptoms. LIMITATIONS: Our findings on age-related differences were based on (repeated) cross-sectional data and require replication in longitudinal studies. CONCLUSIONS: Results yielded a negative association between SOC and mental health problems with increasing magnitude from childhood to young adulthood. Thus, SOC-fostering interventions may help to buffer negative effects of stress and improve resilience starting from early ages.

COVID-19-related distress is associated with analogue PTSD symptoms after exposure to an analogue stressor.

Background: The COVID-19 outbreak in early 2020 was associated with an immediate increase in mental health problems in a significant percentage of the general population. Therefore, it is crucial to investigate how the COVID-19 pandemic - as a psychosocial stressor - affected the aetiological processes of mental disorders. Previous research has shown that stress potentiates associative (fear) learning and analogue symptoms of posttraumatic stress disorder (PTSD) and that analogue PTSD symptoms can emerge in response to associative learning. Objective: We investigated whether distress in response to the COVID-19 outbreak support the development of intrusions and rumination after exposure to a non-COVID-19-related analogue trauma. Moreover, we examined if these effects are mediated by the strength of associative learning during analogue trauma. Method: 122 undergraduate university students participated in an online experiment between March and July 2020. They completed questionnaires measuring distress and rumination related to the COVID-19 outbreak. On a subsequent day, they went through an associative learning task, in which neutral stimuli were paired with the appearance of a highly aversive film clip. Subjective ratings were assessed as indicators of associative learning. On the next day, participants documented film-related intrusions and rumination. Results: COVID-19-related distress but not rumination was associated with post-film intrusion and rumination load. These effects were mediated by associative learning. Conclusions: The current findings are in line with the assumptions that stress enhanced both associative learning and PTSD symptoms. Specifically, they indicate that prolonged psychosocial stress - like during the COVID-19 outbreak - is linked to individual differences in memory processing of aversive events. Further confirmatory research is needed to replicate these results.

Antecedentes: El brote de COVID-19 a principios de 2020 se asoció con un aumento inmediato de problemas de salud mental en un porcentaje significativo de la población general. Por lo tanto, es crucial investigar cómo la pandemia de COVID-19, como estresor psicosocial, afectó los procesos etiológicos de los trastornos mentales. Investigaciones anteriores han demostrado que el estrés potencia el aprendizaje asociativo (miedo) y los síntomas análogos del trastorno de estrés postraumático (TEPT) y que los síntomas análogos del TEPT pueden surgir en respuesta al aprendizaje asociativo.Objetivo: Investigamos si el malestar psicológico en respuesta al brote de COVID-19 contribuye al desarrollo de intrusiones y rumiación después de la exposición a un trauma análogo no relacionado con COVID-19. Además, examinamos si estos efectos están mediados por la fuerza del aprendizaje asociativo durante el trauma analógico.Método: 122 estudiantes universitarios de pregrado participaron en un experimento en línea entre marzo y julio de 2020. Completaron cuestionarios que midieron el malestar psicológico y la rumiación relacionados con el brote de COVID-19. Al día siguiente, realizaron una tarea de aprendizaje asociativo, en la que se emparejaron estímulos neutrales con la exposición a un clip de película altamente aversivo. Las calificaciones subjetivas se evaluaron como indicadores de aprendizaje asociativo. Al día siguiente, los participantes documentaron intrusiones y rumiaciones relacionadas con la película.Resultados: El malestar psicológico relacionado con COVID-19, pero no la rumiación, se asoció con la intrusión posterior a la película y la carga de rumiación. Estos efectos fueron mediados por el aprendizaje asociativo.Conclusiones: Los hallazgos actuales están en línea con las suposiciones de que el estrés potenció tanto el aprendizaje asociativo como los síntomas del TEPT. Específicamente, indican que el estrés psicosocial prolongado, como el ocurrido durante el brote de COVID-19, está relacionado con diferencias individuales en el procesamiento de la memoria de eventos aversivos. Se necesita más investigación confirmatoria para replicar estos resultados.

Adaptive responding to prolonged stress exposure: A binational study on the impact of flexibility on latent profiles of cognitive, emotional and behavioural responses to the COVID-19 pandemic.

The high level of uncertainty brought about by the COVID-19 pandemic has affected the general population's well-being and capacity for adaptive responding. Studies indicate that flexibility, defined as the ability to choose and employ a variety of emotional, cognitive and behavioural strategies in accordance with changing contextual demands, may significantly contribute to adaptive responding to long-term stressors such as COVID-19. In the current study, we aimed to investigate which facets of flexibility predict different latent profiles of adaptive responding to the COVID-19 pandemic in Israel and Germany. A total of 2330 Israelis and 743 Germans completed online questionnaires measuring cognitive and coping regulatory flexibility and cognitive, emotional and behavioural responding to the COVID-19 pandemic. Analyses revealed three distinct response profiles in each country (high, medium and low). These profiles differed in both anxiety and depression symptoms with the non-adaptive response group experiencing clinically relevant symptoms both in Israel and Germany. Additionally, cognitive flexibility and coping flexibility emerged as significant predictors of response profiles in both countries. Training cognitive and coping flexibility may thus help individuals respond more adaptively to psychosocial stressors such as COVID-19. Such training could be selectively administered to less flexible subpopulations as well as adapted to the specific population characteristics.

The relationship between attachment to pets and mental health: the shared link via attachment to humans.

BACKGROUND: Several studies have investigated the relationship between emotional attachment to pets and mental health with the majority of studies finding a negative relationship between emotional attachment to pets and mental health. Interestingly, attachment to pets differs from attachment to humans with studies showing that humans with an insecure attachment style form a particularly strong emotional attachment to their companion animals. Human attachment style is also related to mental health with secure attachment being associated with superior mental health. Building on those findings, the current study aimed at exploring the role of attachment to humans in the relationship between emotional attachment to pets and mental health. METHODS: In this cross-sectional online survey (N = 610) we assessed the strength of emotional attachment to pets and attachment to humans. We further collected pet specific data as well as mental health burden in a sample of German dog owners (Mage=33.12; 92.79% women). We used a mediation model estimating the indirect link between emotional attachment to pets and mental health burden via human attachment and the direct link between emotional attachment to pets and mental health burden simultaneously. RESULTS: We found that attachment to humans fully mediated the positive association between emotional attachment to pets and mental health burden. A stronger emotional attachment to one's dog was associated with lower comfort with depending on or trusting in others, whereby lower comfort with depending on or trusting in others was related to higher mental health burden. Moreover, a stronger attachment to one's dog was also related to a greater fear of being rejected and unloved (Anxiety), which was, in turn, associated with a higher mental health burden. CONCLUSION: Our findings suggest that the positive link between emotional attachment to pets and mental health burden is fully accounted for by its shared variance with insecure attachment to humans in a sample mostly comprising self-identified women. Future studies need to examine whether strong emotional bonds with pets may evolve as a compensatory strategy to buffer difficult childhood bonding experiences.

The long-term buffering effect of sense of coherence on psychopathological symptoms during the first year of the COVID-19 pandemic: A prospective observational study.

The COVID-19 pandemic is a major chronic stressor affecting all societies and almost all individuals. Consequently, research demonstrated a negative impact of COVID-19 on mental health in parts of the general population. However, not all people are affected equally thus making the identification of resilience factors modulating the pandemic's impact on mental health an important research agenda. One of these factors is sense of coherence (SOC), the key component of the salutogenesis framework. The current study aimed at investigating the long-term relationship between SOC and psychopathological symptoms, and the impact of COVID-19-related rumination as its moderator. The prospective observational study assessed psychopathological symptoms and SOC before the COVID-19 outbreak in Germany (February 2020) and at six critical time points during the pandemic in an online panel (n = 1,479). Bivariate latent change score models and latent growth mixture modeling were used to analyze changes in psychopathological symptoms and SOC along with their interaction and to differentiate trajectories of COVID-19-related rumination. A model allowing for unidirectional coupling from SOC to psychopathological symptoms demonstrated best fit. In the total sample, psychopathological symptoms increased significantly over time. Previous SOC predicted later changes in psychopathological symptoms, whereby a stronger SOC was associated with a decrease in symptoms over time. The same pattern of results was evident in the high-rumination (17.2%) but not in the low-rumination group (82.8%). Our findings demonstrate that SOC is an important predictor and modulator of psychopathological symptoms during the COVID-19 pandemic, particularly in those respondents that ruminate about the pandemic.

No distance is too far between friends: associations of comfortable interpersonal distance with PTSD and anxiety symptoms in Israeli firefighters.

Background: Previous research indicates that PTSD patients may show alterations in interpersonal distance regulation (IDR). However, it is not clear whether altered IDR is correlated with psychopathology after trauma and whether attentional processes might be involved in these alterations. Objective: The current study investigated IDR and attentional processing in a sample of Israeli firefighters. Method: Twenty-four participants completed an experimental IDR task as well as measures of PTSD and anxiety. During the task, event-related potentials were recorded to assess attentional processing as reflected in the P1 and N1 components. Results: Participants who did not choose a closer distance towards friends than strangers experienced greater anxiety. Moreover, participants who showed attentional avoidance towards strangers reported more PTSD symptoms. By contrast, participants who showed hypervigilant attention towards strangers reported greater anxiety. Conclusions: Our results demonstrate an association between IDR, PTSD, and anxiety after trauma. Future studies should re-investigate these associations in larger samples and explore potential implications for prevention and treatment.

Antecedentes: Investigaciones anteriores indican que los pacientes con TEPT pueden mostrar alteraciones en la regulación de la distancia interpersonal (IDR en su sigla en inglés). Sin embargo, no está claro si la IDR alterada se correlaciona con la psicopatología después del trauma y si los procesos atencionales podrían estar involucrados en estas alteraciones.Objetivo: El estudio actual investigó la IDR y el procesamiento atencional en una muestra de bomberos israelíes.Método: Veinticuatro participantes completaron una tarea de IDR experimental, así como medidas de TEPT y ansiedad. Durante la tarea, se registraron los potenciales relacionados con evento para evaluar el procesamiento de la atención como se refleja en los componentes P1 y N1.Resultados: Los participantes que no eligieron una distancia más cercana con los amigos que con los extraños experimentaron una mayor ansiedad. Además, los participantes que mostraron evitación atencional hacia extraños reportaron más síntomas de TEPT. Por el contrario, los participantes que mostraron una atención hipervigilante hacia los extraños reportaron una mayor ansiedad.Conclusiones: Nuestros resultados demuestran una asociación entre IDR, TEPT y ansiedad después de un trauma. Los estudios futuros deberían volver a investigar estas asociaciones en muestras más grandes y explorar las posibles implicaciones para la prevención y el tratamiento.

Impact of COVID-19 on Public Mental Health and the Buffering Effect of a Sense of Coherence.

INTRODUCTION: It is claimed that the coronavirus disease 2019 (COVID-19) pandemic has had a negative impact on mental health. However, to date, prospective studies are lacking. Moreover, it is important to identify which factors modulate the stress response to the pandemic. Previously, sense of coherence (SOC) has emerged as a particularly important resistance factor. OBJECTIVE: This prospective study aimed to assess the impact of the COVID-19 outbreak on mental health and to investigate the ability of pre-outbreak SOC levels to predict changes in psychopathological symptoms. METHODS: This study assessed psychopathological symptoms and SOC before and after the COVID-19 outbreak as well as post-outbreak COVID-19-related traumatic distress in a German-speaking sample (n =1,591). Bivariate latent change score (BLCS) modeling was used to analyze pre- to post-outbreak changes in psychopathological symptoms and the ability of SOC to predict symptom changes. RESULTS: Overall, there was no change in psychopathological symptoms. However, on an individual-respondent level, 10% experienced a clinically significant increase in psychopathological symptoms and 15% met cut-off criteria for COVID-19-related traumatic distress. Using BLCS modeling, we identified a high-stress group experiencing an increase in psychopathological symptoms and a decrease in SOC and a low-stress group showing the reversed pattern. Changes in SOC and psychopathological symptoms were predicted by pre-outbreak SOC and psychopathological symptom levels. CONCLUSIONS: Although mental health was stable in most respondents, a small group of respondents characterized by low levels of SOC experienced increased psychopathological symptoms from pre- to post-outbreak. Thus, SOC training might be a promising approach to enhance the resistance to stressors.

Correlates of mental health in occupations at risk for traumatization: a cross-sectional study.

BACKGROUND: Hospitals, police stations, and fire departments are highly demanding workplaces. Staff members are regularly exposed to various stressors including traumatic events. Correspondingly, several studies report high rates of mental health issues among these occupations. Nevertheless, despite these challenging circumstances, some staff members manage to sustain their mental health. The current study is the first to investigate three health-promoting factors simultaneously among three different, highly demanding occupations. METHODS: The present cross-sectional survey investigated health-promoting factors (sense of coherence - SOC, trait-resilience, locus of control - LOC) and mental health outcomes (general psychopathological symptom burden, posttraumatic stress, burnout) in medical staff (n = 223), police officers (n = 257), and firefighters (n = 100). RESULTS: Among all occupations, SOC, trait-resilience, and an internal LOC were negatively associated with general psychopathological symptoms, posttraumatic stress, and burnout symptoms. By contrast, all these outcome measures were positively correlated with an external LOC. Multiple regression models including all health-promoting factors explained 56% of the variance in general psychopathological symptoms and 27% in posttraumatic stress symptoms. Among all occupations, SOC was the strongest predictor of both general psychopathological symptom burden and posttraumatic stress symptoms. Multigroup path analyses revealed minor differences across occupations, mainly driven by a stronger influence of LOC in police officers. CONCLUSION: Across all occupations, SOC was identified as the most important health-promoting factor. Future longitudinal studies should further examine the causal link between health-promoting factors and mental distress in different workplaces. Such studies will also allow for further development and evaluation of resilience promoting programs.

Pre-rehabilitation sense of coherence as a predictor of symptom change after rehabilitation.

Sense of coherence (SOC) constitutes the key component of salutogenesis theory. It reflects individuals' confidence that their environment is comprehensible and manageable and that their lives are meaningful. Research demonstrates a strong cross-sectional relationship between SOC and mental health. However, little is known about SOC's temporal stability and its potential to predict changes in psychopathological symptom severity in different settings. The goal of the current study was to address this gap. The sample of the two-wave longitudinal study consists of 294 patients receiving inpatient psychotherapeutic (and psychopharmacological) treatment for various psychological disorders at a German psychosomatic rehabilitation clinic. SOC (Antonovsky, Social Science & Medicine, 1993, 36, 725-733) and outcome measures (i.e., general mental health problems, depression and anxiety symptoms) were assessed within two days of arrival and at the end of rehabilitation (week 5/6). SOC was significantly enhanced after treatment whereas psychopathological symptoms were significantly reduced. Regression analyses revealed that pre-treatment SOC was a significant negative predictor of post-treatment symptom severity for all outcome measures even after controlling for pre-treatment symptoms. The current findings provide first evidence that SOC is a significant unique predictor of symptom change. Future studies need to further investigate longitudinal associations between SOC and mental health outcomes in different settings.

The Relationship between Dog Ownership, Psychopathological Symptoms and Health-Benefitting Factors in Occupations at Risk for Traumatization.

Individuals working in high-risk occupations (e.g., emergency staff) are exposed to high levels of occupational stress including traumatic events. Correspondingly, several studies report high rates of mental health problems among these occupations. Pet ownership has been associated with better mental health. However, to date a study on the association between pet ownership and indicators of mental health in these occupations is missing. The present cross-sectional survey (N = 580) investigated pet ownership, attachment to pets, health-benefitting factors (i.e., sense of coherence, trait-resilience, locus of control) and psychopathological symptoms (i.e., general mental health problems, posttraumatic stress, burnout) in medical staff, police officers, and firefighters. Dog owners and non-dog owners showed comparable levels of psychopathological distress and health-benefitting factors. Compared to cat owners, dog owners demonstrated stronger emotional attachment to their pet. Moreover, a stronger attachment was also linked to higher levels of psychopathological symptoms and lower levels of health-benefitting factors. However, the relationship between attachment to pets and health-benefitting factors could be explained by their overlap with psychopathological symptom levels. Overall, our findings are not in line with the notion that pet ownership generally has a health-benefitting effect. Future studies need to investigate circumstances that modulate positive effects of pet ownership.

Sleep's impact on emotional recognition memory: A meta-analysis of whole-night, nap, and REM sleep effects.

Numerous studies have shown that post-learning sleep enhances visual episodic recognition memory. However, it remains unclear whether this consolidation benefit is moderated by the emotional valence of the learned material. To clarify whether sleep selectively enhances memory for emotional material, we conducted a meta-analysis including N = 1059 post-sleep/wake observations. Overall, our results do not support this hypothesis. When only studies with a sleep group/wake group comparison were included in the analysis (k = 22), the retention advantage for emotional (negative/positive) over neutral material was not significantly different between sleep and wake groups. When studies without wake groups were included in the analysis after statistical estimation of wake-group parameters, the retention advantage for emotional material was significantly larger in wake groups than in sleep groups (k = 34). Interestingly, however, an additional analysis of eight studies investigating the selective effects of rapid-eye-movement sleep and slow-wave sleep on post-interval emotional memory provided evidence for a selective enhancement of emotional over neutral memory performance after rapid-eye-movement sleep compared to slow-wave sleep. These findings suggest that sleep does not generally enhance visual recognition memory for emotional stimuli. However, the result pattern is consistent with the idea that specific sleep stages preferentially enhance consolidation of emotional and neutral material, respectively.

Differential effects of sleep on explicit and implicit memory for potential trauma reminders: findings from an analogue study.

Background: Recent findings suggest that disruptions of sleep-related memory processing are involved in the development of posttraumatic stress symptoms. More specifically, exposure to an analogue traumatic event resulted in fewer intrusive memories, when it was followed by sleep instead of continued wakefulness. However, competing evidence suggests that sleep deprivation may reduce intrusive re-experiencing. To address these conflicting accounts, we examined how sleep - as opposed to partial sleep deprivation - modulates explicit and implicit trauma memory using an analogue procedure. Methods: Healthy participants (N = 41) were assigned to a Sleep or Partial sleep deprivation group. Prior to nocturnal sleep, both groups were exposed to "traumatic" picture stories. After sleep or partial sleep deprivation, participants were subjected to tests of explicit and implicit memory for potential trauma reminders. Thereafter, participants completed an intrusion triggering task that was embedded in a distractor task. Results: Analyses revealed higher explicit memory for potential trauma reminders after sleep as compared to partial sleep deprivation. No group differences were found for implicit memory. Participants responded with fewer intrusions after sleep than following partial sleep deprivation. Conclusions: The current findings support a protective role of sleep in trauma memory processing, which may be evident after the first night of sleep post-trauma. Although more research is needed, our results corroborate the importance of promoting restful sleep in trauma-exposed individuals.

Antecedentes: hallazgos recientes sugieren que las interrupciones del procesamiento de la memoria relacionada con el sueño están involucradas en el desarrollo de los síntomas de estrés postraumático. Más específicamente, la exposición a un evento traumático análogo resultó en menos recuerdos intrusivos, cuando fue seguido por el sueño en lugar de la vigilia continua. Sin embargo, evidencia contraria sugiere que la falta de sueño puede reducir la reexperimentación intrusiva. Para abordar estos reportes en conflicto, examinamos cómo el sueño, en lugar de la privación parcial del sueño, modula la memoria de trauma explícita e implícita mediante un procedimiento análogo.Métodos: los participantes sanos (N = 41) se asignaron a un grupo de deprivación de sueño total o parcial. Antes del sueño nocturno, ambos grupos fueron expuestos a historias de imágenes 'traumáticas'. Después de la privación total o parcial del sueño, los participantes fueron sometidos a pruebas de memoria explícita e implícita para posibles recuerdos traumáticos. A partir de entonces, los participantes completaron una tarea activadora de recuerdos intrusivos, que se integró en una tarea distractora.Resultados: los análisis revelaron una mayor memoria explícita para recuerdos potencialmente traumáticos después del sueño en comparación con la privación parcial del sueño. No se encontraron diferencias de grupo para la memoria implícita. Los participantes respondieron con menos intrusiones después del sueño que después de la privación parcial del sueño.Conclusiones: Los hallazgos actuales apoyan un papel protector del sueño en el procesamiento de la memoria del trauma, que puede ser evidente después de la primera noche de sueño después del trauma. Aunque se necesita más investigación, nuestros resultados corroboran la importancia de promover el sueño reparador en personas expuestas a traumas.

REM theta activity predicts re-experiencing symptoms after exposure to a traumatic film.

BACKGROUND: Extensive empirical evidence indicates that sleep plays an active role in memory consolidation. Moreover, sleep has been found to preferentially enhance emotional memories and may modulate affective reactions to previously encountered stimuli. Notably, recent findings suggest that disruptions of sleep-related memory processing could be involved in posttraumatic symptom development such that sleep disturbances may accelerate symptoms of intrusive re-experiencing. METHODS: Based on this emerging evidence, we investigated whether an analogue traumatic event would result in immediate impairments of sleep quality in a group of healthy, robust sleepers. In addition, we examined associations between a specific oscillatory correlate of emotional memory consolidation processes (REM theta activity) and subsequent analogue PTSD symptoms. Thirty-three healthy participants entered the study and were exposed to either "traumatic" or neutral films. Thereafter, participants were subjected to an 8.5-hour-long nocturnal sleep opportunity under standardized laboratory conditions including full-night polysomnographic recordings. Ambulatory intrusive memories and subjective symptom ratings were assessed during a period of three consecutive days. RESULTS AND CONCLUSIONS: Our results provide partial support for impaired sleep quality after exposure to a traumatic film. Correlation analyses further reveal that a longer REM sleep duration after "traumatic" exposure predicts reduced analogue PTSD symptoms. Critically, REM theta activity selectively predicts lower re-experiencing symptoms. As previous findings suggest that REM theta activity is reduced in patients with posttraumatic stress disorder, our findings provide a new perspective on the functional role of REM sleep in trauma memory processing.

The Prospective Influence of Trait Alexithymia on Intrusive Memories: What Is the Role of Emotional Recognition Memory?

Posttraumatic stress disorder (PTSD) is often considered to be a disorder of memory as patients suffer from fragmented uncontrollable memories (intrusions) whilst experiencing difficulties in intentionally retrieving details of the traumatic event. Recent research suggests that trait-related deficits in the identification of emotional states (alexithymia) may impact emotional memory processes in a way that promotes intrusion formation in PTSD. Therefore, we investigated the influence of alexithymia on intrusive re-experiencing and emotional recognition memory in a prospective analog study. Twenty-six healthy participants took part in a laboratory experiment, which combined two independent paradigms. Participants were exposed to a traumatic film (first session) and completed an episodic memory task comprising neutral and emotional stimuli (second session). In between sessions, participants recorded intrusive memories of the film. Individuals with higher trait alexithymia (HTA) reported an increased number of intrusions on the day of film presentation. Moreover, analyses of memory performance revealed a negative correlation between alexithymia and emotional recognition memory. Further analyses suggest that reduced emotional recognition memory, as evident in individuals with HTA, may, in turn, be associated with enhanced intrusive re-experiencing. As such, the current findings provide first indications regarding the role of alexithymia in emotional learning and PTSD. Future studies should further investigate these associations as well as potential implications for the treatment of PTSD.