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[创伤后应激障碍中的记忆改变]

[Memory alterations in post-traumatic stress disorder].

作者信息

Da Costa Silva Lucie, Laisney Mickaël, Charretier Laura, Eustache Francis, Quinette Peggy

机构信息

Inserm, U1077, EPHE, UNICAEN, Normandie Université, PSL Université Paris, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine (NIMH), 14000 Caen, France.

出版信息

Biol Aujourdhui. 2023;217(1-2):55-64. doi: 10.1051/jbio/2023018. Epub 2023 Jul 6.

Abstract

Post-Traumatic Stress Disorder (PTSD) is a disorder that develops following the experience of a highly stressful event, which involves a confrontation with death or the threat of death, serious injury or sexual violence. It is characterized by symptoms such as intrusions, avoidance and hypervigilance. According to the literature, PTSD is associated with an imbalance between a privileged memorization of the emotional and sensory aspects of the traumatic event and a failure to memorize the contextual aspects. That is why PTSD is now considered a memory disorder whose effects extend to several components. In this review article, we focus on how PTSD affects long-term memory. The first part describes the long-term effects of PTSD on episodic memory with emphasis on the difficulties in encoding certain elements of the traumatic event and their consequences. These difficulties may be manifested in the narration of the trauma, with a discourse of the traumatic event lacking in contextual details. They may also lead to reliving and generalizing the fear to other contexts, whether they are related to the trauma or not. The second part of the article discusses how PTSD affects autobiographical memory and has consequences for the construction of identity and the perception of the past, present and future of people with this disorder. Autobiographical memory, which plays a key role in the storage of past personal memories as well as in identity formation, shows several forms of disruption induced by PTSD. First, a decrease in contextual details associated with memories of the personal past is observed, meaning that people with PTSD tend to remember their past experiences less accurately. Second, a propensity to project the future in a more negative and unpredictable manner is evidenced, related to a feeling of uncertainty about the future in PTSD suffering individuals. Finally, alterations in the encoding of present events due to the disruptive effects of post-traumatic stress symptoms during the encoding process are also identified.

摘要

创伤后应激障碍(PTSD)是一种在经历高度应激事件后出现的障碍,该事件涉及直面死亡或死亡威胁、严重伤害或性暴力。其特征表现为侵入性症状、回避行为和过度警觉等。根据文献记载,PTSD与创伤事件的情感和感官方面被优先记忆,而情境方面记忆缺失之间的失衡有关。这就是为什么PTSD现在被认为是一种记忆障碍,其影响延伸至多个方面。在这篇综述文章中,我们聚焦于PTSD如何影响长期记忆。第一部分描述了PTSD对情景记忆的长期影响,重点在于对创伤事件某些元素进行编码时的困难及其后果。这些困难可能体现在创伤叙述中,即创伤事件的描述缺乏情境细节。它们还可能导致恐惧在其他情境中重现和泛化,无论这些情境是否与创伤相关。文章的第二部分讨论了PTSD如何影响自传体记忆,以及对患有这种障碍的人的身份构建和对过去、现在及未来的认知产生的后果。自传体记忆在存储过去的个人记忆以及身份形成中起着关键作用,它显示出由PTSD引发的几种形式的破坏。首先,观察到与个人过去记忆相关的情境细节减少,这意味着患有PTSD的人往往对自己过去经历的记忆不够准确。其次,有证据表明他们倾向于以更消极和不可预测的方式投射未来,这与PTSD患者对未来的不确定感有关。最后,还发现由于创伤后应激症状在编码过程中的干扰作用,导致对当前事件编码的改变。

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